Provider Demographics
NPI:1316033483
Name:SALAMON, CHARBEL G (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARBEL
Middle Name:G
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 1:21 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1133
Mailing Address - Country:US
Mailing Address - Phone:321-842-4810
Mailing Address - Fax:321-842-4809
Practice Address - Street 1:21 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1133
Practice Address - Country:US
Practice Address - Phone:321-842-4810
Practice Address - Fax:321-842-4809
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07842700207V00000X, 207VF0040X
ME016585207V00000X
FLME149741207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431867399Medicaid
ME1377Medicare ID - Type Unspecified
ME431867399Medicaid