Provider Demographics
NPI:1568486876
Name:SALAHUB, JOHN (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:SALAHUB
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 TUCK ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7478
Mailing Address - Country:US
Mailing Address - Phone:717-273-5774
Mailing Address - Fax:717-273-9092
Practice Address - Street 1:855 TUCK ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7478
Practice Address - Country:US
Practice Address - Phone:717-273-5774
Practice Address - Fax:717-273-9092
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2012-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003535L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001294684Medicaid
PA6201160001Medicare NSC
PA706215Medicare ID - Type Unspecified
PA001294684Medicaid