Provider Demographics
NPI:1902887789
Name:SALOMON, ALBERT M (DO)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:M
Last Name:SALOMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5400 FRANTZ RD STE 250
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-6102
Mailing Address - Country:US
Mailing Address - Phone:614-533-6535
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:765 N HAMILTON RD
Practice Address - Street 2:SUITE 210
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-8703
Practice Address - Country:US
Practice Address - Phone:614-478-4900
Practice Address - Fax:614-478-7575
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34004574S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0705188Medicaid
OHC03377Medicare UPIN
OH0618575Medicare ID - Type Unspecified