Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 049151 | GA |
NPI | 1407822745 |
---|---|
Provider Name | Dr. Stephen Salvatore Salmieri |
First Address | Lawrenceville, GA 30046-4317 |
Second Address | Lawrenceville, GA 30046-4317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 26/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000883858A | (05) | GA |
000883858G | (05) | GA |
000883858H | (05) | GA |
10578 | KAISER (01) | GA |
5743047 | AETNA (01) | GA |
G05653 | (02) | GA |