Healthcare Provider Details

I. General information

NPI: 1831178060
Provider Name (Legal Business Name): NICOLE M SALOW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 W MAIN ST
MANCHESTER IA
52057-0359
US

IV. Provider business mailing address

709 W MAIN ST P.O. BOX 359
MANCHESTER IA
52057-0359
US

V. Phone/Fax

Practice location:
  • Phone: 563-927-7986
  • Fax: 563-927-7935
Mailing address:
  • Phone: 563-927-7986
  • Fax: 563-927-7935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-33772
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: