Provider Demographics
NPI:1164500237
Name:SALAMAN MARIN, LUIS RAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:RAUL
Last Name:SALAMAN MARIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1122
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-1122
Mailing Address - Country:US
Mailing Address - Phone:787-863-4789
Mailing Address - Fax:787-863-4789
Practice Address - Street 1:AVE. CONQUISTADOR ESQ. CALLE 8
Practice Address - Street 2:5K-1 URB. MONTE BRISAS 5
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-1122
Practice Address - Country:US
Practice Address - Phone:787-863-4789
Practice Address - Fax:787-863-4789
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR5437207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD99548Medicare UPIN
PR0027126Medicare ID - Type Unspecified