Healthcare Provider Details

I. General information

NPI: 1225086333
Provider Name (Legal Business Name): PETER MORRIS SALTZMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 E 30TH ST
FARMINGTON NM
87401
US

IV. Provider business mailing address

PO BOX 2528
FARMINGTON NM
87499
US

V. Phone/Fax

Practice location:
  • Phone: 505-327-0333
  • Fax: 505-327-0159
Mailing address:
  • Phone: 505-327-0333
  • Fax: 505-327-0159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number84-252
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: