Individual
DR. SALIMI ACHJADOE WIRJOSEMITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
915 OLD FERN HILL RD, BUILDING B, SUITE 103, WEST CHESTER, PA 19380-4269
(610) 738-2590
(610) 738-2688
Mailing address
915 OLD FERN HILL RD, BUILDING B, SUITE 103, WEST CHESTER, PA 19380-4269
(610) 738-2590
(610) 738-2688
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
MD054801L
PA
208600000X
Surgery Physician
0101028578
VA
208600000X
Surgery Physician
25MA08122200
NJ
208600000X
Surgery Physician
MD054801L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102424703
—
PA
01
—
MD054801L
PA LICENSE
PA
Enumeration date
09/14/2005
Last updated
08/04/2013
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