Provider Demographics
NPI:1528646973
Name:SALAVITABAR, KAMRON (DO)
Entity type:Individual
Prefix:
First Name:KAMRON
Middle Name:
Last Name:SALAVITABAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3506 KENNETT PIKE STE 230
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-3019
Mailing Address - Country:US
Mailing Address - Phone:302-661-3400
Mailing Address - Fax:302-656-5611
Practice Address - Street 1:3506 KENNETT PIKE STE 230
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-3019
Practice Address - Country:US
Practice Address - Phone:302-661-3400
Practice Address - Fax:302-656-5611
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC2-0024488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine