Provider Demographics
NPI:1730177106
Name:SALAMA, MARYBETH POPE (MD)
Entity type:Individual
Prefix:DR
First Name:MARYBETH
Middle Name:POPE
Last Name:SALAMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:235 ALPHA DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2940
Mailing Address - Country:US
Mailing Address - Phone:412-799-2101
Mailing Address - Fax:412-799-2150
Practice Address - Street 1:235 ALPHA DR
Practice Address - Street 2:SUITE 101
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2940
Practice Address - Country:US
Practice Address - Phone:412-799-2101
Practice Address - Fax:412-799-2150
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043458L207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1257564Medicaid
PAMD043458LOtherMEDICAL LIC NUMBER
PABS2607731OtherFED DEA REG NUMBER
PAE99348Medicare UPIN
PA688581Medicare ID - Type UnspecifiedMEDICARE