Provider Demographics
NPI:1700801016
Name:PALMER, SHAWN L (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:L
Last Name:PALMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2160 E BIDWELL ST
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6453
Mailing Address - Country:US
Mailing Address - Phone:916-983-9823
Mailing Address - Fax:916-983-9623
Practice Address - Street 1:2160 E BIDWELL ST
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6453
Practice Address - Country:US
Practice Address - Phone:916-983-9823
Practice Address - Fax:916-983-9623
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2009-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG66126207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE85707Medicare UPIN