Provider Demographics
NPI:1841685146
Name:SALAMA, GEORGE H (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:H
Last Name:SALAMA
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 1:800 E CHEVES ST STE 350
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2649
Mailing Address - Country:US
Mailing Address - Phone:843-777-7555
Mailing Address - Fax:843-777-7563
Practice Address - Street 1:800 E CHEVES ST STE 350
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2649
Practice Address - Country:US
Practice Address - Phone:843-777-7555
Practice Address - Fax:843-777-7563
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC84802208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program