Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 013534 | ME |
NPI | 1003909896 |
---|---|
Provider Name | Michael John Saletta |
First Address | Waterville, ME 04901-4531 |
Second Address | Waterville, ME 04901-4531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 12/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006984 | ANTHEM (01) | ME |
272270099 | (05) | ME |
304090099 | (05) | ME |
E47985 | (02) |