Provider Demographics
NPI:1497862767
Name:SALEH, MARIA E (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:E
Last Name:SALEH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6400 INDUSTRIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53129-2452
Mailing Address - Country:US
Mailing Address - Phone:866-973-6637
Mailing Address - Fax:414-423-4134
Practice Address - Street 1:355 N PETERS AVE STE 3
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-8115
Practice Address - Country:US
Practice Address - Phone:920-539-5400
Practice Address - Fax:920-486-7070
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI801-025213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43228300Medicaid
BS6410562OtherDEA NUMBER
U75281Medicare UPIN