Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 4301030691 | MI |
N | 207R00000X | Internist | 4301030691 | MI |
N | 111NI0900X | Internist | 4301030691 | MI |
N | 207RA0201X | Internist - Allergy & Immunology | 4301030691 | MI |
NPI | 1174603179 |
---|---|
Provider Name | Dr. Allan I Salomon |
First Address | Southfield, MI 48076-4890 |
Second Address | Farmington Hills, MI 48334-3342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AS5192315 | DEA (01) | MI |
B46102 | (02) | MI |