Provider Demographics
NPI:1356443360
Name:SALTZBERG, DAVID MARK (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MARK
Last Name:SALTZBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6565 N CHARLES ST
Mailing Address - Street 2:SUITE 512
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6800
Mailing Address - Country:US
Mailing Address - Phone:410-583-0300
Mailing Address - Fax:410-583-0307
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:SUITE 512
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:410-583-0300
Practice Address - Fax:410-583-0307
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0031207207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD373371800Medicaid
MD675L21HHMedicare ID - Type Unspecified
MD373371800Medicaid