Provider Demographics
NPI:1275117293
Name:SALAM, KAMIL BASIT (DO)
Entity Type:Individual
Prefix:
First Name:KAMIL
Middle Name:BASIT
Last Name:SALAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5404 CROSS RIVER FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-7849
Mailing Address - Country:US
Mailing Address - Phone:614-806-2751
Mailing Address - Fax:
Practice Address - Street 1:128 E. APPLE AT.
Practice Address - Street 2:FLOOR 2
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:937-208-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program