Provider Demographics
NPI:1114951548
Name:SALMI, ALLEN W (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:W
Last Name:SALMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 COUNTY ROAD C
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:WI
Mailing Address - Zip Code:54162-9607
Mailing Address - Country:US
Mailing Address - Phone:920-360-4115
Mailing Address - Fax:414-290-6755
Practice Address - Street 1:111 E WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4815
Practice Address - Country:US
Practice Address - Phone:414-290-6720
Practice Address - Fax:414-290-6755
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40915-020207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI930075754OtherMEDICARE RAILROAD
WI32568600Medicaid
WI930084902OtherMEDICARE RAILROAD
MI104160595Medicaid
WI0020-07660Medicare ID - Type Unspecified
WI32568600Medicaid
WI0003-40115Medicare ID - Type Unspecified
WI930084902OtherMEDICARE RAILROAD
WI0015-71116Medicare ID - Type Unspecified
WI0015-10006Medicare ID - Type Unspecified