Provider Demographics
NPI:1134108939
Name:SALEM, YOUSEF H (MD)
Entity Type:Individual
Prefix:
First Name:YOUSEF
Middle Name:H
Last Name:SALEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N BEAUREGARD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1735
Mailing Address - Country:US
Mailing Address - Phone:703-680-2111
Mailing Address - Fax:
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:SUITE 735
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:703-370-2132
Practice Address - Fax:703-370-8117
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA046327208800000X
VAVA046327208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010273447Medicaid
F72143Medicare UPIN
512892Medicare ID - Type Unspecified