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NPI Code Detail

MEDICARE: TONI LYNN SALAZAR PA

MEDICARE: TONI LYNN SALAZAR PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1407630619
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONI LYNN SALAZAR PA
Provider Business Mailing Address
First Line : 120 N CENTER ST APT 2
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-4800
Country : US
Telephone Number : 586-944-1958
Fax Number :
Provider Business Practice Location Address
First Line : 44201 DEQUINDRE RD
Second Line :
City : TROY
State : MI
Zip : 48085-1117
Country : US
Telephone Number : 248-964-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2023
Last Update Date : 12/18/2025

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Directions to “ TONI LYNN SALAZAR PA” Practice Location

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