Individual
MARY PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 444-5120
(401) 444-4307
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD09561
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518971100
NPI
RI
05
—
7006394
—
RI
Enumeration date
07/28/2006
Last updated
12/17/2007
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