Provider Demographics
NPI:1770694663
Name:SALAZAR, CAROL MAHON (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:MAHON
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:325 NORTH ST
Mailing Address - Street 2:VA CLINIC
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-1858
Mailing Address - Country:US
Mailing Address - Phone:802-447-6913
Mailing Address - Fax:802-442-2137
Practice Address - Street 1:325 NORTH ST
Practice Address - Street 2:VA CLINIC
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-1858
Practice Address - Country:US
Practice Address - Phone:802-447-6913
Practice Address - Fax:802-442-2137
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT042-0010153207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine