Provider Demographics
NPI:1568441012
Name:SALMAN, WADDAH (MD)
Entity Type:Individual
Prefix:DR
First Name:WADDAH
Middle Name:
Last Name:SALMAN
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 1:6444 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2891
Mailing Address - Country:US
Mailing Address - Phone:904-805-9600
Mailing Address - Fax:904-805-0084
Practice Address - Street 1:6444 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2891
Practice Address - Country:US
Practice Address - Phone:904-805-9600
Practice Address - Fax:904-805-0084
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98532207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4457540Medicaid
MI4457540Medicaid