Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | XX | OH |
N | 222Z00000X | Podiatrist | XX | OH |
Y | 213ES0131X | Foot Surgery | 0103301155 | VA |
NPI | 1104110857 |
---|---|
Provider Name | Dr. Munketh Salem |
First Address | Richmond, VA 23226-2041 |
Second Address | Richmond, VA 23226-2041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2011 |
Last Update Date | 06/02/2017 |