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Individual

DINA G PALMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
6640 INTECH BLVD STE 300, INDIANAPOLIS, IN 46278-2012
(317) 275-8308
(317) 275-6066
Mailing address
6640 INTECH BLVD STE 300, INDIANAPOLIS, IN 46278-2012
(317) 275-8308
(317) 275-6066

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002195
CT
363A00000X
Physician Assistant
Primary
10001245A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D400001392
MEDICARE PTAN
Enumeration date
11/11/2008
Last updated
11/16/2012
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