Provider Demographics
NPI:1558324053
Name:SALEEBY, YUSUF MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:YUSUF
Middle Name:MICHAEL
Last Name:SALEEBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JP
Other - Middle Name:
Other - Last Name:SALEEBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4177
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-4177
Mailing Address - Country:US
Mailing Address - Phone:800-965-8482
Mailing Address - Fax:888-242-0735
Practice Address - Street 1:637-C BELLAMY AVE
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-6472
Practice Address - Country:US
Practice Address - Phone:800-965-8482
Practice Address - Fax:888-242-0735
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21299207P00000X, 208D00000X
GA035994207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00553462LMedicaid
SCG41411Medicaid
GA000553462OMedicaid
SCG35994Medicaid
SCF616439326Medicare PIN
GA00553462LMedicaid
GA93BFBBVMedicare PIN
SCG35994Medicaid
SCG41411Medicaid