Provider Demographics
NPI:1003807496
Name:SALAMA, ADEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEL
Middle Name:M
Last Name:SALAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1111B S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4724
Mailing Address - Country:US
Mailing Address - Phone:540-342-1007
Mailing Address - Fax:540-345-4643
Practice Address - Street 1:1111B S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4724
Practice Address - Country:US
Practice Address - Phone:540-342-1007
Practice Address - Fax:540-345-4643
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVAA103991Medicare PIN
G09448Medicare UPIN