Provider Demographics
NPI:1447833595
Name:SALEM FOOT & ANKLE SPECIALISTS INC
Entity type:Organization
Organization Name:SALEM FOOT & ANKLE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:AWNI
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:540-587-6963
Mailing Address - Street 1:1934 BRAEBURN DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7302
Mailing Address - Country:US
Mailing Address - Phone:540-982-0253
Mailing Address - Fax:540-982-1996
Practice Address - Street 1:876 E MAIN ST UNIT B
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-2904
Practice Address - Country:US
Practice Address - Phone:540-587-6963
Practice Address - Fax:540-587-6962
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALEM FOOT & ANKLE SPECIALISTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty