Basic Information
| Provider Information | |||||||||
| NPI: | 1215976543 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALTIEL | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5943 STADIUM DR | ||||||||
| Address2: | STE 1 | ||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490093016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2695522836 | ||||||||
| FaxNumber: | 2695522964 | ||||||||
| Practice Location | |||||||||
| Address1: | 1722 SHAFFER ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490481633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2693813963 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 06/10/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 036090398 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 4301097457 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 4301097457 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 060039597 | 01 | IL | RRMC-LOCALITY 16 | OTHER | 4396795 | 01 | IL | AETNA | OTHER | L56200 | 01 | IL | MEDICARE PIN-LOCALITY 16 | OTHER | 060051694 | 01 | IL | RRMC-LOCALITY 15 | OTHER | 1316998578 | 01 | IL | NPI GROUP PRACTICE | OTHER | 1616378 | 01 | IL | BCBS | OTHER | L68154 | 01 | IL | MEDICARE PIN-LOCALITY 15 | OTHER |