Organization
DERMATOLOGY LASER SURGERY CENTER INC.
Active
Other names
Dr. Palmer
Organization subpart
No
Provider details
NPI number
Authorized official
GARY D PALMER MD (MEDICAL DOCTOR PRES.)
(937) 433-4922
Entity
Organization
Contact information
Practice address
5 WENGER ROAD, ENGLEWOOD, OH 45322
(937) 832-7555
(937) 830-2227
Mailing address
5 WENGER ROAD, ENGLEWOOD, OH 45322
(937) 433-4922
(937) 433-6520
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
35043172
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
402741848001
MEDICAL MUTUAL
OH
01
—
DE181759
MEDIGAP NUMBER
OH
Enumeration date
03/29/2007
Last updated
08/22/2020
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