Provider Demographics
NPI:1871553446
Name:SALATA, JAMES A (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:SALATA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:1870 AMHERST ST STE 2B
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2841
Practice Address - Country:US
Practice Address - Phone:540-536-2790
Practice Address - Fax:540-536-2791
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2021-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101055466207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6502491Medicaid
VA010148995Medicaid
VA010148995Medicaid
VA040000453Medicare ID - Type Unspecified