Provider Demographics
NPI:1437254950
Name:SALEH, MARY W (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:W
Last Name:SALEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 BENEDICT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2374
Mailing Address - Country:US
Mailing Address - Phone:419-668-1341
Mailing Address - Fax:
Practice Address - Street 1:282 BENEDICT AVE STE B
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2712
Practice Address - Country:US
Practice Address - Phone:419-663-8061
Practice Address - Fax:419-668-2446
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.136262208000000X, 208000000X
IN01061612A208000000X
IDM-136382080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2821389Medicaid
147730EEEEMedicare PIN
I49311Medicare UPIN