DR. JERRY SALAN (NPI# 1265553960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265553960 |
| Entity Type | Individual |
| Full Name | DR. JERRY SALAN |
| Credential | M.D. |
| Practice Address |
13464 Holly Spring Dr Waldorf MD 20601-2329 |
| Practice Telephone | 3018431868 |
| Practice Fax Number | 3013749742 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
D0010296 | MD | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295764363 | Jerry R Salan | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2006-07-01 |
| Street Address |
13464 HOLLY SPRING DR |
| City | WALDORF |
| State | MD |
| Zip Code | 20601-2329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376664060 | Sandra Lee Zucker Salan | Psychiatry & Neurology | 13464 Holly Spring Dr, Waldorf, MD 20601-2329 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154960128 | Sarian Beverly Wilson | Nurse Practitioner | 2203 Kayhill Dr, Waldorf, MD 20601 | 2019-12-23 |
| 1447778055 | Macy Alexandra Forman | Pharmacist | 3061 Tecnology Place, Waldorf, MD 20601 | 2017-09-04 |
| 1922523919 | Gregoire Mcclain | Counselor | Pathways Inc 2670 Crain Hwy, Suite 409, Waldorf, MD 20601 | 2017-08-10 |
| 1477091866 | Lutisse Cooper | Home Health Aide | 2520 Breakwater Court, Waldorf, MD 20601 | 2017-02-06 |
| 1609321637 | Kierra Jordan | Counselor | 2255 Crain Hwy Ste 102, Waldorf, MD 20601 | 2016-08-19 |
| 1215286828 | Linda Kline-lau | Counselor | 2255 Crain Highway, Waldorf, MD 20601 | 2012-08-29 |
| 1205124609 | Marian E. Kirk | Physical Therapist | 2960 Technology Place, Suite 110, Waldorf, MD 20601 | 2011-07-19 |
| 1932345238 | Patient First Maryland Medical Group | Non-Pharmacy Dispensing Site | 2855 Crain Highway, Waldorf, MD 20601 | 2008-12-17 |
| 1720150741 | Marianna Jeanne Patente | Counselor | 2670 Crain Highway, Suite #401, Waldorf, MD 20601 | 2006-11-14 |
| 1407940968 | Harold J. Pincus | Dentist | 2955 Crain Hwy., Waldorf, MD 20601 | 2006-10-02 |
| Find all providers in zip 20601 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437412566 | Awail U Sadiq | Internal Medicine | 12070 Old Line Ctr Ste 303, Waldorf, MD 20602-3535 | 2012-06-22 |
| 1639490840 | Jonathan David Gardner | Internal Medicine | 12070 Old Line Ctr Ste 303, Waldorf, MD 20602-3535 | 2010-06-22 |
| 1760587596 | Samuel B Itscoitz | Internal Medicine | 12070 Old Line Ctr Ste 303, Waldorf, MD 20602-3535 | 2006-09-14 |
| 1669585113 | Chesapeake&washington Heart Care, PC | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2006-08-17 |
| 1790702157 | Jeffrey B Trabb | Internal Medicine | 2670 Crain Hwy, Suite 300, Waldorf, MD 20601-2806 | 2006-07-15 |
| 1699714469 | Maryland Healthcare Associates LLC | Internal Medicine | 12070 Old Line Ctr, Suite 100, Waldorf, MD 20602-2513 | 2006-06-06 |
| 1669438933 | Terrance A. Collins | Internal Medicine | 2670 Crain Hwy, Suite 300, Waldorf, MD 20601-2806 | 2006-04-25 |
| 1699746271 | Thomas B Haywood | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2006-01-31 |
| 1356322598 | Satish Jumani | Internal Medicine | 12070 Old Line Ctr, Suite 202, Waldorf, MD 20602-2513 | 2005-11-07 |
| 1740261924 | Gopalakrishnan Srinivasan | Internal Medicine | 3510 Old Washington Road, Suite 100, Waldorf, MD 20602-3234 | 2005-11-07 |
| Find all providers in WALDORF | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.