Provider Demographics
NPI:1801886932
Name:PALMER, CHAD COLETTI (MD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:COLETTI
Last Name:PALMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3114
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85271
Mailing Address - Country:US
Mailing Address - Phone:480-425-5063
Mailing Address - Fax:480-425-5010
Practice Address - Street 1:3501 N SCOTTSDALE RD
Practice Address - Street 2:STE 130
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251
Practice Address - Country:US
Practice Address - Phone:480-425-5000
Practice Address - Fax:480-425-5033
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ325402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ872459Medicaid
AZ872459Medicaid
AZ80530Medicare PIN
AZ80440Medicare PIN
AZ80442Medicare PIN