Healthcare Provider Details

I. General information

NPI: 1730177106
Provider Name (Legal Business Name): MARYBETH POPE SALAMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 ALPHA DR SUITE 101
PITTSBURGH PA
15238-2940
US

IV. Provider business mailing address

235 ALPHA DR SUITE 101
PITTSBURGH PA
15238-2940
US

V. Phone/Fax

Practice location:
  • Phone: 412-799-2101
  • Fax: 412-799-2150
Mailing address:
  • Phone: 412-799-2101
  • Fax: 412-799-2150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD043458L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD043458L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: