Provider Demographics
NPI:1407822745
Name:SALMIERI, STEPHEN SALVATORE (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:SALVATORE
Last Name:SALMIERI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 OLD NORCROSS RD
Mailing Address - Street 2:SUITE 910
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4317
Mailing Address - Country:US
Mailing Address - Phone:404-303-3750
Mailing Address - Fax:404-252-4755
Practice Address - Street 1:759 OLD NORCROSS RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4317
Practice Address - Country:US
Practice Address - Phone:678-442-3121
Practice Address - Fax:678-376-4045
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049151207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000883858HMedicaid
GA000883858GMedicaid
GA10578OtherKAISER
GA5743047OtherAETNA
GA000883858AMedicaid
GAG05653Medicare UPIN
GA000883858AMedicaid