Provider Demographics
NPI:1275520322
Name:SALAMON, SAMUEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:M
Last Name:SALAMON
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 1:26300 EUCLID AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3708
Mailing Address - Country:US
Mailing Address - Phone:216-574-8900
Mailing Address - Fax:216-325-0352
Practice Address - Street 1:26300 EUCLID AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3708
Practice Address - Country:US
Practice Address - Phone:216-574-8900
Practice Address - Fax:216-325-0352
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051956174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0594307Medicaid
OH0594307Medicaid
OH0570534Medicare PIN