Provider Demographics
NPI:1407974462
Name:SALGUEIRO, JESUS M (MD)
Entity Type:Individual
Prefix:MR
First Name:JESUS
Middle Name:M
Last Name:SALGUEIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BOX 7379
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7379
Mailing Address - Country:US
Mailing Address - Phone:787-746-5454
Mailing Address - Fax:787-746-5455
Practice Address - Street 1:500 AVE DEGETAU SUITE 404
Practice Address - Street 2:HIMA PLAZA I
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-5454
Practice Address - Fax:787-746-5455
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13475207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH44438Medicare UPIN
PR26174DMedicare ID - Type Unspecified