Provider Demographics
NPI:1285600932
Name:MIDHA, SALIL K (MD)
Entity type:Individual
Prefix:
First Name:SALIL
Middle Name:K
Last Name:MIDHA
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 1:50 TREMONT ST
Mailing Address - Street 2:SUITE #104
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-2721
Mailing Address - Country:US
Mailing Address - Phone:781-662-6404
Mailing Address - Fax:781-665-0658
Practice Address - Street 1:50 TREMONT ST
Practice Address - Street 2:SUITE #104
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-2721
Practice Address - Country:US
Practice Address - Phone:781-662-6404
Practice Address - Fax:781-665-0658
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44642207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease