MEDICARE: DR. ALBERT TIMOTHY SALOOM M.D.

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	207Q00000X	Family Medicine Physician	MD-071720-L	PA

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	:	1992733299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT TIMOTHY SALOOM M.D.

Provider Business Mailing Address
First Line	:	6533 ROUTE 819
Second Line	:
City	:	MOUNT PLEASANT
State	:	PA
Zip	:	15666-2665
Country	:	US
Telephone Number	:	724-547-5501
Fax Number	:	724-547-5510

Provider Business Practice Location Address
First Line	:	6533 ROUTE 819
Second Line	:
City	:	MOUNT PLEASANT
State	:	PA
Zip	:	15666-2665
Country	:	US
Telephone Number	:	724-547-5501
Fax Number	:	724-547-5510

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	09/30/2014

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