Provider Demographics
NPI:1265666770
Name:SALAS, EDGAR RUBEN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:RUBEN
Last Name:SALAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:216 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1832
Mailing Address - Country:US
Mailing Address - Phone:859-239-5860
Mailing Address - Fax:859-239-5869
Practice Address - Street 1:216 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1832
Practice Address - Country:US
Practice Address - Phone:859-239-5860
Practice Address - Fax:859-239-5869
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY45409207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine