Provider Demographics
NPI:1710366968
Name:CALO, SAL MANUEL SEBASTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SAL MANUEL SEBASTIAN
Middle Name:
Last Name:CALO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAL
Other - Middle Name:
Other - Last Name:CALO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-2600
Mailing Address - Fax:313-874-7989
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-2600
Practice Address - Fax:313-874-7989
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301510070207RP1001X
IL125067528207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease