Provider Demographics
NPI:1326400938
Name:SALEM, JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:SALEM
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 1:240 CETRONIA RD STE 200N
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9182
Mailing Address - Country:US
Mailing Address - Phone:484-426-2600
Mailing Address - Fax:833-816-7512
Practice Address - Street 1:240 CETRONIA RD STE 200N
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9182
Practice Address - Country:US
Practice Address - Phone:484-426-2600
Practice Address - Fax:833-816-7512
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD469687208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery