Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 7478 | SD |
NPI | 1063510691 |
---|---|
Provider Name | John Palmer |
First Address | Rapid City, SD 57701-4679 |
Second Address | Rapid City, SD 57701-4679 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 31/10/2019 |