Provider Demographics
NPI:1447216668
Name:SALEEM, REHAN (MD)
Entity Type:Individual
Prefix:
First Name:REHAN
Middle Name:
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 1:14410 SOMMERVILLE CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-6835
Mailing Address - Country:US
Mailing Address - Phone:804-897-9355
Mailing Address - Fax:804-897-9359
Practice Address - Street 1:14410 SOMMERVILLE CT
Practice Address - Street 2:SUITE 101
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6835
Practice Address - Country:US
Practice Address - Phone:804-897-9355
Practice Address - Fax:804-897-9359
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012360732084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010388D99Medicare PIN