Provider Demographics
NPI:1487644829
Name:SALVATORE, DONALD E (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:SALVATORE
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 1:275 MAMMOTH ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109
Mailing Address - Country:US
Mailing Address - Phone:603-663-8300
Mailing Address - Fax:603-663-8349
Practice Address - Street 1:275 MAMMOTH ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109
Practice Address - Country:US
Practice Address - Phone:603-663-8300
Practice Address - Fax:603-663-8349
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9171208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0109657YPNH01OtherANTHEM ACES PIN
NH2127OtherCIGNA PIN
NHF67039OtherHPHC
NHP667617OtherOXFORD PIN
NH30006964Medicaid
NH12-40732OtherUHC PIN
NH2192446OtherAETNA PIN
NH20169YOtherANTHEM REFERRING RAN
NH406455OtherTUFTS PIN
NH20169YOtherANTHEM REFERRING RAN
NHRE7565Medicare PIN