Provider Demographics
NPI:1700813417
Name:PALMER, ELIZABETH A (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:PALMER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:CENTRAL MICHIGAN UNIVERSITY HEALTH SERVICES
Mailing Address - Street 2:FOUST HALL 249
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48859-0001
Mailing Address - Country:US
Mailing Address - Phone:959-774-1748
Mailing Address - Fax:989-774-4335
Practice Address - Street 1:CENTRAL MICHIGAN UNIVERSITY HEALTH SERVICES
Practice Address - Street 2:FOUST HALL 249
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48859-0001
Practice Address - Country:US
Practice Address - Phone:959-774-1748
Practice Address - Fax:989-774-4335
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-01-23
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Provider Licenses
StateLicense IDTaxonomies
MI4301081976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00350565OtherRAILROAD MEDICARE PTAN
MI0291176OtherBCBS
MIE96008026Medicare PIN