Individual
DR. ALLEN J SALEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2442 E. 25TH ST., IDAHO FALLS, ID 83404-0000
(208) 552-4909
(940) 612-3636
Mailing address
2442 E. 25TH ST., IDAHO FALLS, ID 83404-0000
(208) 552-4909
(940) 612-3636
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
K9165
TX
207RP1001X
Pulmonary Disease Physician
Primary
K9165
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
K9165
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0033HG
BCBS
TX
01
—
0033HGT
BCBS
TX
05
—
042379003
—
TX
Enumeration date
08/16/2005
Last updated
11/22/2011
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