Provider Demographics
NPI:1598967911
Name:SALARI, NIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIMA
Middle Name:
Last Name:SALARI
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 1:1635 E MYRTLE AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5556
Mailing Address - Country:US
Mailing Address - Phone:602-944-2900
Mailing Address - Fax:602-944-0064
Practice Address - Street 1:1635 E MYRTLE AVE
Practice Address - Street 2:STE 400
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5556
Practice Address - Country:US
Practice Address - Phone:602-944-2900
Practice Address - Fax:602-944-0064
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ47480207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ159645Medicare PIN