Provider Demographics
NPI:1215918826
Name:SALVADOR, CAROLINA (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:
Last Name:SALVADOR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:800-647-2098
Mailing Address - Fax:314-362-3192
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM MEDICAL ONCOLOGY, STE 7A, 7B, 7C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:800-647-2098
Practice Address - Fax:314-362-3192
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021045484207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200106245Medicaid
AL134934Medicaid
AL134935Medicaid
KY64089550Medicaid
ALZ50036OtherVIVA
MS05585711Medicaid
AL051122357OtherBCBS
AL051122553OtherBCBS
AL134933Medicaid
AL051122553OtherBCBS
MS05585711Medicaid
AL134933Medicaid