Provider Demographics
NPI:1265697783
Name:PALMER, SETH CHARLES (DO)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:CHARLES
Last Name:PALMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 N. WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424
Mailing Address - Country:US
Mailing Address - Phone:616-994-2770
Mailing Address - Fax:616-920-6533
Practice Address - Street 1:3100 N. WELLNESS DR
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424
Practice Address - Country:US
Practice Address - Phone:616-994-2770
Practice Address - Fax:616-920-6533
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017138207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1265697783Medicaid
MI1265697783Medicaid
MIW8000AMedicare PIN