Provider Demographics
NPI:1659478485
Name:SHENANDOAH HEAD AND NECK SPECIALISTS, PLC
Entity Type:Organization
Organization Name:SHENANDOAH HEAD AND NECK SPECIALISTS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SALATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-722-7282
Mailing Address - Street 1:136 LINDEN DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6900
Mailing Address - Country:US
Mailing Address - Phone:540-722-7282
Mailing Address - Fax:
Practice Address - Street 1:142 LINDEN DR
Practice Address - Street 2:SUITE 106
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6901
Practice Address - Country:US
Practice Address - Phone:540-722-7282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADD2064OtherMCRR GROUP
VADD2064OtherMCRR GROUP