Provider Demographics
NPI:1033226303
Name:SALEM, YASSER S (MD)
Entity Type:Individual
Prefix:DR
First Name:YASSER
Middle Name:S
Last Name:SALEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YASSER
Other - Middle Name:SALAH
Other - Last Name:SALEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1281 MARINETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-2018
Mailing Address - Country:US
Mailing Address - Phone:715-330-7090
Mailing Address - Fax:715-732-0828
Practice Address - Street 1:1281 MARINETTE AVE
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-2018
Practice Address - Country:US
Practice Address - Phone:715-330-7090
Practice Address - Fax:715-732-0828
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-104820207R00000X
IN01076879A207RA0001X, 207RC0000X
WI47840207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34634000Medicaid
WI011140120Medicare PIN
WII29251Medicare UPIN