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General NPI Number Information
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NPI Number | 1972728400
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Entity Type | Individual
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Provider Name | MICHAEL JONATHAN SALATA MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVENUE THIRD FLOOR
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City | CLEVELAND
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State | OH
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Zip | 44106
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Country | US
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Telephone | 216-844-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 24701 EUCLID AVENUE 3RD FLOOR, MAIL STOP NET 6099
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City | EUCLID
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State | OH
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Zip | 44117
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Country | US
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Telephone |
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Fax | 216-844-5970
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 036123170
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 35.095437
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License Number State | OH
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