Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 34965 | DC |
N | 208600000X | Surgeon | 34965 | DC |
N | 2082S0105X | Plastic Hand Surgeon | 01062440A | IN |
Y | 2082S0105X | Plastic Hand Surgeon | 39636 | KY |
NPI | 1922008747 |
---|---|
Provider Name | Michelle D. Palazzo |
First Address | Louisville, KY 40201-7441 |
Second Address | Louisville, KY 40202-1846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2005 |
Last Update Date | 28/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I15608 | (02) |