Provider Demographics
NPI:1124052733
Name:PALERMO, GERALD A (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:A
Last Name:PALERMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6949 GOOD SAMARITAN DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-5204
Mailing Address - Country:US
Mailing Address - Phone:513-931-2400
Mailing Address - Fax:513-931-2429
Practice Address - Street 1:6949 GOOD SAMARITAN DR
Practice Address - Street 2:SUITE 210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-5204
Practice Address - Country:US
Practice Address - Phone:513-931-2400
Practice Address - Fax:513-931-2429
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035033207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0309366Medicaid
OHPA0424646Medicare PIN
OH0309366Medicaid