Provider Demographics
NPI:1417434408
Name:PALMER, IFEANYI
Entity type:Individual
Prefix:MR
First Name:IFEANYI
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-3283
Mailing Address - Country:US
Mailing Address - Phone:440-317-1596
Mailing Address - Fax:
Practice Address - Street 1:385 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-3283
Practice Address - Country:US
Practice Address - Phone:440-317-1596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)