Provider Demographics
NPI:1114936804
Name:GULRUKH SALEEM INC
Entity Type:Organization
Organization Name:GULRUKH SALEEM INC
Other - Org Name:GULRUKH SALEEM, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GULRUKH
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-209-3732
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20146-0664
Mailing Address - Country:US
Mailing Address - Phone:703-209-3732
Mailing Address - Fax:703-349-6476
Practice Address - Street 1:44075 PIPELINE PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5881
Practice Address - Country:US
Practice Address - Phone:703-209-3732
Practice Address - Fax:703-349-6476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232354207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA202284OtherBCBS ANTHEM
VA1750376562OtherINDIVIDUAL NPI
VA1750376562OtherINDIVIDUAL NPI
VA202284OtherBCBS ANTHEM