Provider Demographics
NPI:1366569329
Name:SALEMIS, JAMES CONSTANTINOS (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CONSTANTINOS
Last Name:SALEMIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DIMITRIOS
Other - Middle Name:CONSTANTINOS
Other - Last Name:SALEMIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:149 BELGRADE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2416
Mailing Address - Country:US
Mailing Address - Phone:617-327-4698
Mailing Address - Fax:617-327-9587
Practice Address - Street 1:149 BELGRADE AVE
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-2416
Practice Address - Country:US
Practice Address - Phone:617-327-4698
Practice Address - Fax:617-327-9587
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80185207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3134024Medicaid
MA3134024Medicaid
MAJ30834Medicare ID - Type Unspecified