Provider Demographics
NPI:1508803453
Name:SALVADOR, ALBERT SIMBUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:SIMBUL
Last Name:SALVADOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-3213
Mailing Address - Country:US
Mailing Address - Phone:215-467-7400
Mailing Address - Fax:215-467-7401
Practice Address - Street 1:2112 S 7TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-3213
Practice Address - Country:US
Practice Address - Phone:215-467-7400
Practice Address - Fax:215-467-7401
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021873E204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00008951420008Medicaid
PW0008951420009Medicaid
PW0008951420009Medicaid