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NPI 1104201086

NPI 1104201086 : MARTHA SALEK M.D. : MEMPHIS, TN

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General NPI Number Information
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    NPI Number           |    1104201086
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    Entity Type          |    Individual 
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    Provider Name        |    MARTHA SALEK M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/21/2015
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    Last Update Date     |    04/23/2025
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Provider Practice Location Address
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    Address Line         |    262 DANNY THOMAS PL 
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    City                 |    MEMPHIS
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    State                |    TN
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    Zip                  |    38105-3678
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    Country              |    US
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    Telephone            |    413-794-0000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    262 DANNY THOMAS PL # MS 515 
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    City                 |    MEMPHIS
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    State                |    TN
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    Zip                  |    38105-3678
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    Country              |    US
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    Telephone            |    413-794-0000
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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        |    2080H0002X
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    Taxonomy Name        |    Pediatric Hospice and Palliative Medicine Physician
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    License Number       |    62346
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    License Number State |    TN
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    263439
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    License Number State |    MA
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Taxonomy #3
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    Taxonomy Code        |    2080P0207X
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    Taxonomy Name        |    Pediatric Hematology & Oncology Physician
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    License Number       |    62346
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    License Number State |    TN
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