Provider Demographics
NPI:1497962617
Name:SALEM B FOAD M D INCORPORATED
Entity Type:Organization
Organization Name:SALEM B FOAD M D INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:OTTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-984-3022
Mailing Address - Street 1:7730 MONTGOMERY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4283
Mailing Address - Country:US
Mailing Address - Phone:513-984-3022
Mailing Address - Fax:513-984-4705
Practice Address - Street 1:7730 MONTGOMERY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4283
Practice Address - Country:US
Practice Address - Phone:513-984-3022
Practice Address - Fax:513-984-4705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35034854F261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0289138Medicaid
OH0289138Medicaid
OH9181161Medicare ID - Type UnspecifiedMEDICARE GROUP