Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 030698 | CT |
N | 208600000X | Surgeon | 030698 | CT |
Y | 2086X0206X | Surgical Oncologist | 030698 | CT |
NPI | 1285615062 |
---|---|
Provider Name | Ronald R Salem |
First Address | New Haven, CT 06536-0805 |
Second Address | New Haven, CT 06519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 03/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001306986 | (05) | CT |
E40008 | (02) |