Provider Demographics
NPI:1720643018
Name:SALEM FOOT & ANKLE SPECIALISTS INC
Entity Type:Organization
Organization Name:SALEM FOOT & ANKLE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-982-0253
Mailing Address - Street 1:1934 BRAEBURN DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7302
Mailing Address - Country:US
Mailing Address - Phone:540-982-0253
Mailing Address - Fax:540-982-1996
Practice Address - Street 1:1934 BRAEBURN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7302
Practice Address - Country:US
Practice Address - Phone:540-982-0253
Practice Address - Fax:540-982-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty