Provider Demographics
NPI:1003861964
Name:SALAMA, DANIEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:SALAMA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 MONROE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3058
Mailing Address - Country:US
Mailing Address - Phone:313-274-0990
Mailing Address - Fax:313-274-8120
Practice Address - Street 1:2200 MONROE ST STE 1
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3058
Practice Address - Country:US
Practice Address - Phone:313-274-0990
Practice Address - Fax:313-274-8120
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001380213E00000X, 213ES0103X
MIDS001380213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4856353910OtherBCBSM PIN
MI3045060Medicaid
MI4856353910OtherBCBSM PIN
MI3045060Medicaid
T34201Medicare UPIN