Provider Demographics
NPI:1871567149
Name:SALTIN, COREY B (DO)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:B
Last Name:SALTIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-466-4549
Mailing Address - Fax:978-466-4575
Practice Address - Street 1:50 MEMORIAL DRIVE
Practice Address - Street 2:SUITE 113
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-466-2692
Practice Address - Fax:978-466-4754
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213237207R00000X, 207RA0201X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2121247Medicaid
MA2116294Medicaid
420157OtherTUFTS
AA53540OtherHARVARD PILGRIM
J29788OtherBLUE CROSS OF MASS
9771476OtherGROUP MEDICAID
420157OtherTUFTS
MA2121247Medicaid
MAA3965501Medicare PIN