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General NPI Number Information
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NPI Number | 1053492348
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Entity Type | Individual
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Provider Name | CHEVONNE TENILLE SALMON-RAY MD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 6525 BELCREST RD KAISER PERMANENTE PRINCE GEORGE'S MEDICAL CENTER
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City | HYATTSVILLE
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State | MD
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Zip | 20782-2003
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Country | US
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Telephone | 301-209-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 E JEFFERSON ST KAISER PERMANENTE REGIONAL OFFICE
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City | ROCKVILLE
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State | MD
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Zip | 20852-4908
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Country | US
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Telephone | 301-816-2424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101240485
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D67611
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License Number State | MD
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