Individual
KIMBERLY HEIDIG SALATA
Active
Individual
KIMBERLY HEIDIG SALATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101052972
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718029
MT STATE
WV
05
—
007602413
—
VA
01
—
250011482
RAILROAD MEDICARE
—
01
—
256937
ANTHEM
VA
05
—
6800040000
—
WV
Enumeration date
03/17/2006
Last updated
11/08/2021
Update your record
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