Provider Demographics
NPI:1821154071
Name:SALTER, BARRY M (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:M
Last Name:SALTER
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 1:1 BRICKYARD LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1686
Mailing Address - Country:US
Mailing Address - Phone:207-363-6008
Mailing Address - Fax:207-363-6015
Practice Address - Street 1:1 BRICKYARD LN
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1686
Practice Address - Country:US
Practice Address - Phone:207-363-6008
Practice Address - Fax:207-363-6015
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME008524207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME231180000Medicaid
ME231180000Medicaid
B86420Medicare UPIN