Provider Demographics
NPI:1437269362
Name:SALVADOR, GARY B (PA C)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:B
Last Name:SALVADOR
Suffix:
Gender:M
Credentials:PA C
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Mailing Address - Street 1:1 ORTHOPEDICS DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1668
Mailing Address - Country:US
Mailing Address - Phone:978-818-6350
Mailing Address - Fax:978-818-6355
Practice Address - Street 1:1 ORTHOPEDICS DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1668
Practice Address - Country:US
Practice Address - Phone:978-818-6350
Practice Address - Fax:978-818-6355
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-06-30
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Provider Licenses
StateLicense IDTaxonomies
MA1916207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q63671Medicare UPIN
AP2592Medicare ID - Type Unspecified