Provider Demographics
NPI:1003812793
Name:FAM, SALWA A (MD)
Entity Type:Individual
Prefix:
First Name:SALWA
Middle Name:A
Last Name:FAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:475 FRANKLIN ST
Mailing Address - Street 2:STE 203
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6265
Mailing Address - Country:US
Mailing Address - Phone:508-879-4407
Mailing Address - Fax:508-620-9395
Practice Address - Street 1:475 FRANKLIN ST
Practice Address - Street 2:STE 203
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6265
Practice Address - Country:US
Practice Address - Phone:508-879-4407
Practice Address - Fax:508-620-9395
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2010-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA44666208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0108553Medicaid
A36710Medicare UPIN
MA0108553Medicaid