Provider Demographics
NPI:1770545972
Name:SALERNO, RAMO A (OD)
Entity type:Individual
Prefix:DR
First Name:RAMO
Middle Name:A
Last Name:SALERNO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:RAY
Other - Middle Name:A
Other - Last Name:SALERNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:26771 W 12 MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1539
Mailing Address - Country:US
Mailing Address - Phone:248-644-0644
Mailing Address - Fax:248-827-3675
Practice Address - Street 1:26771 W 12 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1539
Practice Address - Country:US
Practice Address - Phone:248-644-0644
Practice Address - Fax:248-827-3675
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI002872152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI945106218Medicaid
MI0P46720OtherMEDICARE GROUP NUMBER
MIP46720001Medicare PIN
U25864Medicare UPIN