Provider Demographics
NPI:1114241296
Name:ABDUS-SALAAM, SAYYIDA SHAKOOR (MD)
Entity Type:Individual
Prefix:MRS
First Name:SAYYIDA
Middle Name:SHAKOOR
Last Name:ABDUS-SALAAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 KING DR
Mailing Address - Street 2:SUITE 808
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2922
Mailing Address - Country:US
Mailing Address - Phone:937-304-3877
Mailing Address - Fax:
Practice Address - Street 1:500 KING DR
Practice Address - Street 2:SUITE 808
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2922
Practice Address - Country:US
Practice Address - Phone:937-304-3877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035946207N00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207N00000XAllopathic & Osteopathic PhysiciansDermatology