Provider Demographics
NPI:1619064656
Name:SALAMA, HANY S (MD)
Entity Type:Individual
Prefix:
First Name:HANY
Middle Name:S
Last Name:SALAMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8790 WATSON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-5140
Mailing Address - Country:US
Mailing Address - Phone:314-543-2800
Mailing Address - Fax:314-543-2801
Practice Address - Street 1:8790 WATSON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5140
Practice Address - Country:US
Practice Address - Phone:314-543-2800
Practice Address - Fax:314-543-2801
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2017-06-23
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Provider Licenses
StateLicense IDTaxonomies
MO105872207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
113912OtherBCBS
MO6232830001OtherPTAN
110229073OtherRR MCR
MO208890814Medicaid
MO6232830001OtherPTAN
110229073OtherRR MCR