Provider Demographics
NPI:1386038586
Name:PALM, KASEY MARIE (MD)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:MARIE
Last Name:PALM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-566-2727
Mailing Address - Fax:614-566-2712
Practice Address - Street 1:10190 US HIGHWAY 42 STE 210C
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9525
Practice Address - Country:US
Practice Address - Phone:614-566-2727
Practice Address - Fax:614-566-2712
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME156083207VF0040X
OH35.130384207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery