Provider Demographics
NPI:1265635924
Name:SALKENI, MOHAMAD ADHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:ADHAM
Last Name:SALKENI
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 1:8613 LEE HWY # 200N
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2171
Mailing Address - Country:US
Mailing Address - Phone:571-350-8400
Mailing Address - Fax:703-280-9596
Practice Address - Street 1:8613 LEE HWY # 200N
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2171
Practice Address - Country:US
Practice Address - Phone:571-350-8400
Practice Address - Fax:703-280-9596
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006015694207R00000X
VA0101275055207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC2F0229OtherMEDICARE DC METRO
VA1265635924Medicaid