Individual
DR. PATRICK WILLIAM PALUMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, AAPS
Contact information
Practice address
8206 LEESBURG PIKE STE 401, VIENNA, VA 22182-2614
(703) 356-5666
Mailing address
334 ELDEN ST, HERNDON, VA 20170-4818
(571) 665-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101044923
VA
208600000X
Surgery Physician
0101044923
VA
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005406118
AETNA PPO
VA
01
—
010076633
VA MCDE
VA
01
—
138097
ANTHEM INSURANCE
VA
01
—
3559401
AETNA HMO
VA
01
—
84 1633951
TAX ID #
VA
Enumeration date
11/28/2006
Last updated
11/23/2016
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