Provider Demographics
NPI:1326230681
Name:SALAHEDDINE TOMEH MD PC
Entity Type:Organization
Organization Name:SALAHEDDINE TOMEH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-942-6166
Mailing Address - Street 1:333 W THOMAS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4425
Mailing Address - Country:US
Mailing Address - Phone:602-942-6166
Mailing Address - Fax:602-942-6188
Practice Address - Street 1:333 W THOMAS RD STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4425
Practice Address - Country:US
Practice Address - Phone:602-942-6166
Practice Address - Fax:602-942-6188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ105135Medicare PIN