Provider Demographics
NPI:1790780088
Name:SALOMON, RICHARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:SALOMON
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 1:1985 TATE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1433
Mailing Address - Country:US
Mailing Address - Phone:828-328-4449
Mailing Address - Fax:828-328-4809
Practice Address - Street 1:1985 TATE BLVD SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1433
Practice Address - Country:US
Practice Address - Phone:828-328-4449
Practice Address - Fax:828-328-4809
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2007-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27302174400000X, 207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC74262OtherBCBS INDIVIDUAL NUMBER
NC790247AMedicaid
NC0247AOtherBCBS GROUP NUMBER
NC1295845386OtherGROUP NPI NUMBER
NC8974262Medicaid
NC2325143Medicare ID - Type UnspecifiedGROUP NUMBER
NC8974262Medicaid
NC210122BMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBR