Provider Demographics
NPI:1093777690
Name:SALTIS, LAWRENCE M (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:M
Last Name:SALTIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:701 WHITE POND DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1127
Mailing Address - Country:US
Mailing Address - Phone:330-572-1011
Mailing Address - Fax:330-572-1018
Practice Address - Street 1:701 WHITE POND DR
Practice Address - Street 2:SUITE 300
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1127
Practice Address - Country:US
Practice Address - Phone:330-572-1011
Practice Address - Fax:330-572-1018
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35033727S2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0218320Medicaid
OH100279OtherKAISER
OH0218320Medicaid
OH131937185OtherRAILROAD MEDICARE
OH000000127226OtherANTHEM BLUECROSS/BLUESHEI
OH341097565EOtherSUMMACARE
OH728986OtherBUCKEYE COMMUNITY HEALTH
OHSA0374862Medicare PIN