Provider Demographics
NPI:1063595924
Name:MARTIN E. SALM, M.D., LTD.
Entity type:Organization
Organization Name:MARTIN E. SALM, M.D., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SALM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-588-5000
Mailing Address - Street 1:276 KINGSBURY GRADE, SUITE 101
Mailing Address - Street 2:P.O. BOX 5910
Mailing Address - City:STATELINE
Mailing Address - State:NV
Mailing Address - Zip Code:89449-5910
Mailing Address - Country:US
Mailing Address - Phone:775-588-5000
Mailing Address - Fax:775-588-5001
Practice Address - Street 1:276 KINGSBURY GRADE, SUITE 101
Practice Address - Street 2:
Practice Address - City:STATELINE
Practice Address - State:NV
Practice Address - Zip Code:89449-5910
Practice Address - Country:US
Practice Address - Phone:775-588-5000
Practice Address - Fax:775-588-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6357207ND0101X, 207ND0900X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002003058Medicaid
NV002003058Medicaid
NVV102228Medicare PIN