Healthcare Provider Details

I. General information

NPI: 1851910178
Provider Name (Legal Business Name): KRYSTAL SALAZAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 W 16TH ST
INDIANAPOLIS IN
46202-2207
US

IV. Provider business mailing address

1921 N TALBOTT ST
INDIANAPOLIS IN
46202-1533
US

V. Phone/Fax

Practice location:
  • Phone: 317-963-7288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number01096893A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: