Provider Demographics
NPI:1366681512
Name:NIKHAT SALAMAT PULMONARY ASSOCIATES LLC
Entity Type:Organization
Organization Name:NIKHAT SALAMAT PULMONARY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARI
Authorized Official - Middle Name:F
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-660-3191
Mailing Address - Street 1:727 CRAIG RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7175
Mailing Address - Country:US
Mailing Address - Phone:314-660-3191
Mailing Address - Fax:314-835-9218
Practice Address - Street 1:727 CRAIG RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7175
Practice Address - Country:US
Practice Address - Phone:314-660-3191
Practice Address - Fax:314-835-9218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004035776207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA1578Medicare PIN
MOPENDINGMedicare PIN