Healthcare Provider Details

I. General information

NPI: 1407630619
Provider Name (Legal Business Name): TONI LYNN SALAZAR PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONI LYNN LEWIS PA-C

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44201 DEQUINDRE RD
TROY MI
48085-1117
US

IV. Provider business mailing address

120 N CENTER ST APT 2
ROYAL OAK MI
48067-4800
US

V. Phone/Fax

Practice location:
  • Phone: 248-964-5000
  • Fax:
Mailing address:
  • Phone: 586-944-1958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: