Provider Demographics
NPI:1619080306
Name:SALAMEH, JAWAD A (MD)
Entity Type:Individual
Prefix:
First Name:JAWAD
Middle Name:A
Last Name:SALAMEH
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 1:1 PENN CTR W
Mailing Address - Street 2:SUITE 225
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15276-0109
Mailing Address - Country:US
Mailing Address - Phone:412-788-4995
Mailing Address - Fax:
Practice Address - Street 1:792 N CENTER AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1026
Practice Address - Country:US
Practice Address - Phone:814-443-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043323L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
110107865OtherRAILROAD MEDICARE
PA767846OtherHIGHMARK BLUE SHIELD
PA0012750520014Medicaid
716077Medicare PIN
PA767846OtherHIGHMARK BLUE SHIELD