Doctor Name: | JAIME NUGUID SALOMON |
NPI Number: | 1174615157 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 01028799A |
Business Practice Address: | 11020 E 10th St Unit B Indianapolis, IN - 462293710 |
Business Phone Number: | 3178985800 |
Business Fax Number: | 3178985883 |
Mailing Address: | 11020 E 10th St Unit B, INDIANAPOLIS |
State: | IN |
Postal Code: | 462293710 |
Phone Number: | 3178985800 |
Fax Number: | 3178985883 |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 09/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01028799A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |