Provider Demographics
NPI:1952396459
Name:SALOM, EMERY M (MD)
Entity Type:Individual
Prefix:
First Name:EMERY
Middle Name:M
Last Name:SALOM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12741 MIRAMAR PKWY
Mailing Address - Street 2:STE 302
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2905
Mailing Address - Country:US
Mailing Address - Phone:954-602-9723
Mailing Address - Fax:954-602-9724
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:SUITE 702
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-828-8688
Practice Address - Fax:305-828-8655
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2016-05-27
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Provider Licenses
StateLicense IDTaxonomies
FLME77021207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000021064-WOtherHUMANA PROVIDER NUMBER
FL1952396459OtherMD MEDICARE CHOICE
FL0296791OtherGHI PROVIDER NUMBER
FL50345OtherNEIGHBORHOOD PROV. #
FL270790000Medicaid
FL7136647OtherAETNA PROVIDER NUMBER
FL326631OtherWELLCARE PROVIDER NUMBER
FL3604OtherTOTAL HLTH CH. PROV. #
FL8641070-001OtherCIGNA HMO PROVIDER NUMBER
FL969333OtherUSA MNGD. CR. PROV. #
FLGS076660OtherVISTA PROVIDER NUMBER
FL295791OtherAVMED THRU PARITY PROV. #
FL52127OtherBCBS OF FL. PROVIDER #
FL8641070-002OtherCIGNA PPO PROVIDER NUMBER
FL3604OtherTOTAL HLTH CH. PROV. #
FL7136647OtherAETNA PROVIDER NUMBER