Individual
DR. TODD RANDALL PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6030
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5288
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003876600
—
ID
Enumeration date
03/13/2007
Last updated
06/10/2009
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