Provider Demographics
NPI:1558331298
Name:SALEEBY, MANHAL (MD)
Entity Type:Individual
Prefix:
First Name:MANHAL
Middle Name:
Last Name:SALEEBY
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 1:140 E FERRELL ST
Mailing Address - Street 2:PO BOX 623
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-2102
Mailing Address - Country:US
Mailing Address - Phone:434-447-3261
Mailing Address - Fax:434-447-3307
Practice Address - Street 1:413 BRACEY LN
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1632
Practice Address - Country:US
Practice Address - Phone:434-447-3261
Practice Address - Fax:434-447-3307
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233344207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000108E66Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
VAH74498Medicare UPIN