Healthcare Provider Details

I. General information

NPI: 1497962617
Provider Name (Legal Business Name): SALEM B FOAD M D INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7730 MONTGOMERY RD SUITE 200
CINCINNATI OH
45236-4283
US

IV. Provider business mailing address

7730 MONTGOMERY RD SUITE 200
CINCINNATI OH
45236-4283
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-3022
  • Fax: 513-984-4705
Mailing address:
  • Phone: 513-984-3022
  • Fax: 513-984-4705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number35034854F
License Number StateOH

VIII. Authorized Official

Name: MRS. LINDA OTTO
Title or Position: OFFICE MANAGER
Credential:
Phone: 513-984-3022