Provider Demographics
NPI:1316214695
Name:SALERNO, MARK P (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:P
Last Name:SALERNO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:11361 N 99TH AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-5470
Mailing Address - Country:US
Mailing Address - Phone:602-636-4605
Mailing Address - Fax:623-972-6173
Practice Address - Street 1:11361 N 99TH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-5470
Practice Address - Country:US
Practice Address - Phone:602-636-4605
Practice Address - Fax:623-972-6173
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
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Provider Licenses
StateLicense IDTaxonomies
AZ25300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics