Provider Demographics
NPI:1255348439
Name:SALAMA, JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SALAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31000 LAHSER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4847
Mailing Address - Country:US
Mailing Address - Phone:248-647-0660
Mailing Address - Fax:248-647-5389
Practice Address - Street 1:31000 LAHSER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-4847
Practice Address - Country:US
Practice Address - Phone:248-647-0660
Practice Address - Fax:248-647-5389
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301036477207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2126351Medicaid
MI06353251OtherBCBS OF MICHIGAN ID NUMBE
MI06353251OtherBCBS OF MICHIGAN ID NUMBE
MIB45205Medicare UPIN
MI0630423Medicare ID - Type Unspecified