Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 35-080173 | OH |
NPI | 1528088747 |
---|---|
Provider Name | Mark R Palmert |
First Address | Shaker Hts, OH 44122-5203 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 14/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000219527 | ANTHEM (01) | OH |
000000526116 | ANTHEM (01) | OH |
2287850 | (05) | OH |
2287850 | BCMH (01) | OH |
7206021 | AETNA (01) | OH |
H49700 | (02) | OH |