Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 0101236671 | VA |
Y | 2081P2900X | Pain Medicine | 0101236671 | VA |
NPI | 1295772457 |
---|---|
Provider Name | Michael J Depalma |
First Address | Richmond, VA 23235-1947 |
Second Address | Richmond, VA 23235-1947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 20/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010142954 | (05) | VA |
H84152 | (02) | VA |