Provider Demographics
NPI:1073503769
Name:MERAM, SALIM (MD)
Entity Type:Individual
Prefix:
First Name:SALIM
Middle Name:
Last Name:MERAM
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 1:11900 E 12 MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-3400
Mailing Address - Country:US
Mailing Address - Phone:586-573-5890
Mailing Address - Fax:586-573-5525
Practice Address - Street 1:11900 E 12 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3400
Practice Address - Country:US
Practice Address - Phone:586-573-5890
Practice Address - Fax:586-573-5525
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301071071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110248452OtherRAILROAD MEDICARE PTAN
MICG3113OtherRAILROAD MEDICARE GROUP NUMBER
MI700H249730OtherBCBS GROUP NUMBER
MI4627570Medicaid
MI700H249730OtherBCBS GROUP NUMBER
MI4627570Medicaid