Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD043458L | PA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD043458L | PA |
NPI | 1730177106 |
---|---|
Provider Name | Dr. Marybeth Pope Salama |
First Address | Pittsburgh, PA 15238-2940 |
Second Address | Pittsburgh, PA 15238-2940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 22/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1257564 | (05) | PA |
BS2607731 | FED DEA REG NUMBER (01) | PA |
E99348 | (02) | PA |
MD043458L | MEDICAL LIC NUMBER (01) | PA |