Provider Demographics
NPI:1639384100
Name:SALOOM, SALEM GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:SALEM
Middle Name:GEORGE
Last Name:SALOOM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:159 WHETSTONE ST
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36460-2625
Mailing Address - Country:US
Mailing Address - Phone:251-743-7486
Mailing Address - Fax:251-743-7400
Practice Address - Street 1:159 WHETSTONE ST
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-2625
Practice Address - Country:US
Practice Address - Phone:251-743-7486
Practice Address - Fax:251-743-7400
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL6911208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery