MEDICARE: DR. MAYER SALAMA DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	MS000918	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407939432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAYER SALAMA DPM

Provider Business Mailing Address
First Line	:	2200 MONROE ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3058
Country	:	US
Telephone Number	:	313-274-0990
Fax Number	:	313-274-8120

Provider Business Practice Location Address
First Line	:	18600 VAN HORN RD
Second Line	:
City	:	WOODHAVEN
State	:	MI
Zip	:	48183-3828
Country	:	US
Telephone Number	:	734-675-2440
Fax Number	:	734-675-6738

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/12/2009

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