Provider Demographics
NPI:1164420154
Name:SALAS, LOUIS A (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:A
Last Name:SALAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 GEIPE RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4147
Mailing Address - Country:US
Mailing Address - Phone:410-247-7500
Mailing Address - Fax:410-247-4227
Practice Address - Street 1:700 GEIPE RD
Practice Address - Street 2:SUITE 230
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4147
Practice Address - Country:US
Practice Address - Phone:410-247-7500
Practice Address - Fax:410-247-4227
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0037913207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD079151200Medicaid
MDE84736Medicare UPIN
MD079151200Medicaid