Provider Demographics
NPI:1679991244
Name:SALAZAR, DANIELLE (BS, MA, MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:BS, MA, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:DEPT OF SURGERY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-3536
Mailing Address - Fax:202-877-3699
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-3536
Practice Address - Fax:202-877-3699
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMD0472872086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program