Provider Demographics
NPI:1720072077
Name:SALKEY, PAUL H (PA-C)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:H
Last Name:SALKEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5544 GREENWICH RD STE 200
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6563
Mailing Address - Country:US
Mailing Address - Phone:757-466-0089
Mailing Address - Fax:757-466-8017
Practice Address - Street 1:5544 GREENWICH RD STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6563
Practice Address - Country:US
Practice Address - Phone:757-466-0089
Practice Address - Fax:757-466-8017
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001119207P00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1720072077Medicaid
VA10037235OtherSENTARA HEALTH NETWORK
VA10037235OtherOPTIMA HEALTH
VAP00637377OtherRAILROAD MEDICARE
VA10037235OtherOPTIMA HEALTH
VA10037235OtherSENTARA HEALTH NETWORK