Provider Demographics
NPI:1356012207
Name:SALOUS, MOTAZ HILMI (PHARMD)
Entity Type:Individual
Prefix:
First Name:MOTAZ
Middle Name:HILMI
Last Name:SALOUS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3341
Mailing Address - Country:US
Mailing Address - Phone:540-723-6102
Mailing Address - Fax:
Practice Address - Street 1:1725 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3341
Practice Address - Country:US
Practice Address - Phone:540-723-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202219589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist