Provider Demographics
NPI:1689430456
Name:SALEH, MOHAMMED HASSAN
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:HASSAN
Last Name:SALEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12450 INDEPENDENCE CT APT A7
Mailing Address - Street 2:
Mailing Address - City:PRINCESS ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21853-3022
Mailing Address - Country:US
Mailing Address - Phone:443-735-5914
Mailing Address - Fax:
Practice Address - Street 1:30182 SUSSEX HWY UNIT 1
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:DE
Practice Address - Zip Code:19956-3884
Practice Address - Country:US
Practice Address - Phone:302-875-8560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0016013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist