Provider Demographics
NPI:1255866463
Name:PALOMBA, KRISTEN MICHELE (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MICHELE
Last Name:PALOMBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:
Practice Address - Street 1:IHA PALLIATIVE CARE
Practice Address - Street 2:5301 E HURON RIVER DRIVE SUITE 2119
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1117
Practice Address - Country:US
Practice Address - Phone:734-712-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC227343390200000X
MI4301502101207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty