Provider Demographics
NPI:1255644902
Name:SALTER, AMANDA BREE (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:BREE
Last Name:SALTER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31700 TELEGRAPH RD STE 140
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-3466
Mailing Address - Country:US
Mailing Address - Phone:248-688-0234
Mailing Address - Fax:248-780-6071
Practice Address - Street 1:31700 TELEGRAPH RD STE 140
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-3466
Practice Address - Country:US
Practice Address - Phone:248-688-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096080207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4406532Medicaid
MI0M88850OtherMEDICARE
MI4406532Medicaid