Provider Demographics
NPI:1194952796
Name:JAMES M SALANDER, MD PA
Entity type:Organization
Organization Name:JAMES M SALANDER, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:SALANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-881-5503
Mailing Address - Street 1:11119 ROCKVILLE PILE
Mailing Address - Street 2:#204
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-881-5503
Mailing Address - Fax:301-881-0213
Practice Address - Street 1:11119 ROCKVILLE PILE
Practice Address - Street 2:#204
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-881-5503
Practice Address - Fax:301-881-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD390642086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD550271300Medicaid
MDE29965Medicare UPIN
MD550271300Medicaid