Provider Demographics
NPI:1194037093
Name:SALVADOR, PATRICIA DIZON (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:DIZON
Last Name:SALVADOR
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 1:2314 SASSAFRAS ST STE 310
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2721
Mailing Address - Country:US
Mailing Address - Phone:814-456-6194
Mailing Address - Fax:814-452-5777
Practice Address - Street 1:2314 SASSAFRAS ST
Practice Address - Street 2:STE 310
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2722
Practice Address - Country:US
Practice Address - Phone:814-456-6194
Practice Address - Fax:814-452-5777
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.023824207R00000X
PAMD454395207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine