Provider Demographics
NPI:1215976543
Name:SALTIEL, FRANK S (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:S
Last Name:SALTIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5943 STADIUM DR
Mailing Address - Street 2:STE 1
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-3016
Mailing Address - Country:US
Mailing Address - Phone:269-552-2836
Mailing Address - Fax:269-552-2964
Practice Address - Street 1:1722 SHAFFER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1633
Practice Address - Country:US
Practice Address - Phone:269-381-3963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090398207RC0000X
MI4301097457207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL060039597OtherRRMC-LOCALITY 16
IL4396795OtherAETNA
ILL56200OtherMEDICARE PIN-LOCALITY 16
IL060051694OtherRRMC-LOCALITY 15
IL1316998578OtherNPI GROUP PRACTICE
IL1616378OtherBCBS
ILL68154OtherMEDICARE PIN-LOCALITY 15
ILL68154OtherMEDICARE PIN-LOCALITY 15