Provider Demographics
NPI:1861494213
Name:SALM, RICHARD J (DPM)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:SALM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:681 GOODLETTE RD N
Mailing Address - Street 2:#160
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5458
Mailing Address - Country:US
Mailing Address - Phone:239-263-0200
Mailing Address - Fax:239-263-8435
Practice Address - Street 1:681 GOODLETTE RD N
Practice Address - Street 2:#160
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5458
Practice Address - Country:US
Practice Address - Phone:239-263-0200
Practice Address - Fax:239-263-8435
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO2579213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390341900Medicaid
FL65493AMedicare ID - Type Unspecified
FL4521140001Medicare NSC
FL63994Medicare UPIN