Provider Demographics
NPI:1760462931
Name:SALZMAN, KEITH L (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:L
Last Name:SALZMAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 W GREEN LAKE DR N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4828
Mailing Address - Country:US
Mailing Address - Phone:256-363-1642
Mailing Address - Fax:
Practice Address - Street 1:7317 W GREEN LAKE DR N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-4828
Practice Address - Country:US
Practice Address - Phone:256-363-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-22
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045389L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine