Provider Demographics
NPI:1134206741
Name:PALMER, RICHARD L (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:PALMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 OLD BRANCH AVE
Mailing Address - Street 2:SUITE 409
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1608
Mailing Address - Country:US
Mailing Address - Phone:301-868-7121
Mailing Address - Fax:301-877-1934
Practice Address - Street 1:1328 SOUTHERN AVE SE
Practice Address - Street 2:SUITE 310
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4689
Practice Address - Country:US
Practice Address - Phone:202-562-0400
Practice Address - Fax:202-562-8619
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD31979207RN0300X
MDD0055120207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0771 0007OtherBLUE CHOICE
DC034639100Medicaid
DC0771 0007OtherCAREFIRST
92500OtherAMERIGROUP
517465OtherMDIPA/OPTIMUM CHOICE
17082OtherCHARTERED
1965OtherELDER HEALTH
004489K44Medicare ID - Type Unspecified
17082OtherCHARTERED
H07239Medicare UPIN