Provider Demographics
NPI:1891880845
Name:SOLOMON, DONALD M (DPM)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:M
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:23423 RYAN
Mailing Address - Street 2:DONALD SOLOMON DPM
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48091-1927
Mailing Address - Country:US
Mailing Address - Phone:586-755-0022
Mailing Address - Fax:586-755-0066
Practice Address - Street 1:23423 RYAN
Practice Address - Street 2:DONALD SOLOMON DPM
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-1927
Practice Address - Country:US
Practice Address - Phone:586-755-0022
Practice Address - Fax:586-755-0066
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIDS000554213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1020492Medicaid
MI1020492Medicaid
5635272Medicare ID - Type Unspecified