Provider Demographics
NPI:1316385719
Name:SALTZMAN, BRYAN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:MICHAEL
Last Name:SALTZMAN
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 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 PENNSYLVANIA PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46280-1393
Practice Address - Country:US
Practice Address - Phone:317-944-9400
Practice Address - Fax:317-968-1098
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-00018207X00000X
IN01093306A207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300090061Medicaid
NC1316385719Medicaid
IN364430319OtherMEDICARE PTAN
NC0397730007OtherNSC #
IN1102823137OtherANTHEM PTAN
INQ00808564OtherRAILROAD PTAN
SCNC3382Medicaid