Provider Demographics
NPI:1033204805
Name:SALVATORE, DAWN MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIA
Last Name:SALVATORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S 11TH ST
Mailing Address - Street 2:SUITE 6270
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4824
Mailing Address - Country:US
Mailing Address - Phone:215-955-6540
Mailing Address - Fax:215-923-0835
Practice Address - Street 1:111 S 11TH ST
Practice Address - Street 2:SUITE 6270
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-6540
Practice Address - Fax:215-923-0835
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057954A2086S0129X
PAMD4454072086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001857413Medicaid
NJ0307840Medicaid
PA001857413Medicaid
NJ0307840Medicaid
INF59362Medicare UPIN