Provider Demographics
NPI:1053492348
Name:SALMON-RAY, CHEVONNE TENILLE (MD)
Entity type:Individual
Prefix:DR
First Name:CHEVONNE
Middle Name:TENILLE
Last Name:SALMON-RAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHEVONNE
Other - Middle Name:TENILLE
Other - Last Name:SALMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE REGIONAL OFFICE
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:6525 BELCREST RD
Practice Address - Street 2:KAISER PERMANENTE PRINCE GEORGE'S MEDICAL CENTER
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2003
Practice Address - Country:US
Practice Address - Phone:301-209-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240485207Q00000X
MDD67611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine