Provider Demographics
NPI:1104286293
Name:SALMON, GEORGE HENRY
Entity type:Individual
Prefix:
First Name:GEORGE HENRY
Middle Name:
Last Name:SALMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 COLESVILLE RD
Mailing Address - Street 2:APT 824
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4343
Mailing Address - Country:US
Mailing Address - Phone:443-775-1823
Mailing Address - Fax:
Practice Address - Street 1:8811 COLESVILLE RD
Practice Address - Street 2:APT 824
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4343
Practice Address - Country:US
Practice Address - Phone:443-775-1823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD309177225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist