Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301502245 | MI |
N | 208000000X | Pediatrician | MT203902 | PA |
Y | 2080P0210X | Pediatric Nephrologist | 4301502245 | MI |
N | 2080P0210X | Pediatric Nephrologist | MT203902 | PA |
NPI | 1497192173 |
---|---|
Provider Name | Dr. Eloise Salmon |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 20/08/2020 |