Provider Demographics
NPI:1023471570
Name:PALMA-ZAMORA, ISAAC
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:PALMA-ZAMORA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ISAAC
Other - Middle Name:
Other - Last Name:PALMA-ZAMORA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:GRADUATE MEDICAL EDUCATION
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-1601
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:GRADUATE MEDICAL EDUCATION
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-1601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU2599208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics