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NPI Code Detail

MEDICARE: GARY SALEM, D.O., PC

MEDICARE: GARY SALEM, D.O., PC
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
1207R00000XInternal Medicine Physician5101008983MI

General Provider Information

NPI Number : 1841522018
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARY SALEM, D.O., PC
Provider Business Mailing Address
First Line : PO BOX 343
Second Line :
City : GRAND BLANC
State : MI
Zip : 48480-0343
Country : US
Telephone Number : 313-590-9170
Fax Number :
Provider Business Practice Location Address
First Line : 13137 N CLIO RD
Second Line :
City : CLIO
State : MI
Zip : 48420-1028
Country : US
Telephone Number : 810-686-2600
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : GARY S SALEM
Credential : D.O.
Telephone Number : 313-590-9170
Provider Enumeration Date : 02/12/2010
Last Update Date : 05/09/2023

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