Provider Demographics
NPI:1497564975
Name:SALAZAR, IRWIN DENNIS (CSA)
Entity type:Individual
Prefix:MR
First Name:IRWIN
Middle Name:DENNIS
Last Name:SALAZAR
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 PEARL POINT CT
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1575
Mailing Address - Country:US
Mailing Address - Phone:443-995-3547
Mailing Address - Fax:
Practice Address - Street 1:2121 I ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20052-0086
Practice Address - Country:US
Practice Address - Phone:202-994-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR146934163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical