Provider Demographics
NPI:1548725781
Name:PALMETTO MEDICINE, LLC
Entity type:Organization
Organization Name:PALMETTO MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:EMMER II
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-518-5781
Mailing Address - Street 1:148 WATERLOO ST SW STE 3
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3766
Mailing Address - Country:US
Mailing Address - Phone:803-335-4362
Mailing Address - Fax:
Practice Address - Street 1:148 WATERLOO ST SW STE 3
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3766
Practice Address - Country:US
Practice Address - Phone:803-335-4362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty