Provider Demographics
NPI:1306831524
Name:SALEEM, MOHAMMAD A (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:A
Last Name:SALEEM
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:P.O.BOX 460 RT. 590
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:PA
Mailing Address - Zip Code:18427
Mailing Address - Country:US
Mailing Address - Phone:570-689-2300
Mailing Address - Fax:
Practice Address - Street 1:543 HAMLIN HIGHWAY
Practice Address - Street 2:RT. 590
Practice Address - City:HAMLIN
Practice Address - State:PA
Practice Address - Zip Code:18427
Practice Address - Country:US
Practice Address - Phone:570-689-2300
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038791L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SA129854Medicare ID - Type Unspecified
PAD68791Medicare UPIN