Provider Demographics
NPI:1487144143
Name:SALTAGI, MOHAMAD Z (MD)
Entity type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:Z
Last Name:SALTAGI
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:PO BOX 858 MC CA410
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:717-531-5814
Mailing Address - Fax:717-531-0494
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-6822
Practice Address - Fax:717-531-4907
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11019817A390200000X
PAMD481461207Y00000X
IN01094240A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN11019817AOtherINDIANA PROFESSIONAL LICENSING AGENCY - POSTGRADUATE TRAINING PERMIT