Provider Demographics
NPI:1629045810
Name:NERI-NIXON, MARIA SALVACION L (MD)
Entity Type:Individual
Prefix:
First Name:MARIA SALVACION
Middle Name:L
Last Name:NERI-NIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA SALVACION
Other - Middle Name:L
Other - Last Name:NERI-NIXON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3110 VILLAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-8900
Mailing Address - Country:US
Mailing Address - Phone:440-899-5555
Mailing Address - Fax:440-899-1140
Practice Address - Street 1:30033 CLEMENS RD
Practice Address - Street 2:WL 10
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1021
Practice Address - Country:US
Practice Address - Phone:440-899-5555
Practice Address - Fax:440-899-1140
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081963N207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000541197OtherANTHEM
OH2370698Medicaid
9273172OtherMEDICARE GROUP PHYSICIAN
000000541197OtherANTHEM
4099443Medicare PIN