Organization
E J SALON MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELY J SALON M.D. (PRSIDENT)
(304) 252-8541
Entity
Organization
Contact information
Practice address
200 RALEIGH AVE, BECKLEY, WV 25801-5944
(304) 252-8541
(304) 253-2507
Mailing address
200 RALEIGH AVE, BECKLEY, WV 25801-5944
(304) 252-8541
(304) 253-2507
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18381
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001722335
BLUE CROSS BLUE SHIELD
WV
05
—
0079492000
—
WV
Enumeration date
02/16/2007
Last updated
06/10/2008
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