Individual
GABRIEL PAGE PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-2161
Mailing address
PO BOX 9649, BOISE, ID 83707-4649
(208) 472-8162
(208) 472-8172
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M-14681
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699017772
—
VA
Enumeration date
03/26/2013
Last updated
06/16/2020
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