Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 028303 | GA |
NPI | 1528167590 |
---|---|
Provider Name | Glenn P. Palmisano |
First Address | Savannah, GA 31411-2955 |
Second Address | Savannah, GA 31411-2955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E01155 | (02) |