Provider Demographics
NPI:1215913140
Name:SALTZBURG, MICHAEL C (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:SALTZBURG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:615 HOWARD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4813
Mailing Address - Country:US
Mailing Address - Phone:814-946-3336
Mailing Address - Fax:814-946-0621
Practice Address - Street 1:615 HOWARD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4813
Practice Address - Country:US
Practice Address - Phone:814-946-3336
Practice Address - Fax:814-946-0621
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS-004068-L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA006382OtherPA BLUE SHIELD
PAOS-004068-LOtherPA STATE LICENSE
PA113252OtherHEALTH AMERICA
PA301432OtherUPMC HEALTH PLAN
1502605OtherUMWA HEALTH & RETIREMENT
P00431081OtherRAILROAD MEDICARE
6687850001OtherDMEPOS SUPPLIER PTAN
PAOS-004068-LOtherPA STATE LICENSE
PA006382OtherPA BLUE SHIELD