Individual
DR. EDWIN LINCOLN PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, WHT 289 RADIOLOGICAL ASSOCIATES, BOSTON, MA 02114-2621
(617) 726-8782
(617) 726-6165
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-8782
(617) 726-6165
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
49988
MA
2085N0904X
Nuclear Radiology Physician
Primary
49988
MA
2085R0202X
Diagnostic Radiology Physician
49988
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2087383
—
MA
01
—
727723
TUFTS HEALTH PLAN
MA
01
—
C15102
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
08/09/2012
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