Healthcare Provider Details

I. General information

NPI: 1780868778
Provider Name (Legal Business Name): WILLIAM LEE SALOMON M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 12/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 COBB RD
POLAND ME
04274-6361
US

IV. Provider business mailing address

79 COBB RD
POLAND ME
04274-6361
US

V. Phone/Fax

Practice location:
  • Phone: 207-998-5521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number13237
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246ZB0600X
TaxonomyBiostatiscian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: