Provider Demographics
NPI:1649243635
Name:SALIS, ARI I (MD)
Entity Type:Individual
Prefix:DR
First Name:ARI
Middle Name:I
Last Name:SALIS
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 1:2 1/2 BEACON ST STE 199
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4447
Mailing Address - Country:US
Mailing Address - Phone:603-228-1521
Mailing Address - Fax:603-225-2510
Practice Address - Street 1:248 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2588
Practice Address - Country:US
Practice Address - Phone:603-228-1521
Practice Address - Fax:603-225-2510
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00572362085R0202X, 2085R0204X
VA01012396232085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKA80OtherB/C B/S
VA010267943Medicaid
MD781502600Medicaid
MDJ062OtherB/C B/S
DC2849OtherB/C B/S
VA010267978Medicaid
VA01267960Medicaid
MDG99293Medicare UPIN
MD435LA359Medicare ID - Type UnspecifiedLOCALITY/JURIS. CODE 02
MDCN2566Medicare ID - Type UnspecifiedRAILROAD MEDICARE
VA010267943Medicaid
VA010267960Medicare ID - Type Unspecified
DEDD4343Medicare ID - Type UnspecifiedRAILROAD MEDICARE
VA010267978Medicaid