Provider Demographics
NPI:1487625661
Name:SALAME, MAHOMED Y (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHOMED
Middle Name:Y
Last Name:SALAME
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 1:901 LEIGHTON AVE
Mailing Address - Street 2:SUITE 702
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5700
Mailing Address - Country:US
Mailing Address - Phone:256-231-2552
Mailing Address - Fax:
Practice Address - Street 1:1031 QUINTARD AVE STE 1A
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-5714
Practice Address - Country:US
Practice Address - Phone:256-231-2552
Practice Address - Fax:256-231-2550
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25751207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051522720OtherBCBS
AL264378757OtherCHAMPUS GROUP
AL051522720OtherBCBS GROUP
AL111755Medicaid
AL051522720OtherBCBS
AL264378757OtherCHAMPUS GROUP