Provider Demographics
NPI:1235189317
Name:SALATKA, KARL WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:WILLIAM
Last Name:SALATKA
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 1:638 FOURTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6505
Mailing Address - Country:US
Mailing Address - Phone:724-339-2229
Mailing Address - Fax:724-339-7733
Practice Address - Street 1:638 FOURTH AVE
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6505
Practice Address - Country:US
Practice Address - Phone:724-339-2229
Practice Address - Fax:724-339-7733
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 014819 E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000620220Medicaid
PA0006202200001Medicaid
B35125Medicare UPIN
PA078043Medicare PIN