Provider Demographics
NPI:1245611409
Name:ABDELSALAM, WAEL
Entity Type:Individual
Prefix:
First Name:WAEL
Middle Name:
Last Name:ABDELSALAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 S KITTREDGE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4010
Mailing Address - Country:US
Mailing Address - Phone:303-503-3838
Mailing Address - Fax:
Practice Address - Street 1:1334 S KITTREDGE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4010
Practice Address - Country:US
Practice Address - Phone:303-503-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41989261343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41989261Medicaid