Individual
CLARO TESORO PALMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
822 INDUSTRIAL BLVD STE 100, ELLIJAY, GA 30540-3804
(706) 515-7030
Mailing address
2727 PACES FERRY RD SE STE 1-1100, ATLANTA, GA 30339-6151
(470) 271-3418
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
82720
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133629
—
IA
01
—
42141730753
JOHN DEERE HEALTH INS PLA
IA
01
—
52996
WELLMARK INS PLAN
IA
Enumeration date
05/20/2006
Last updated
07/08/2019
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