Provider Demographics
NPI:1710332846
Name:SALEH, BELAL HAMID ALI (DO)
Entity Type:Individual
Prefix:DR
First Name:BELAL
Middle Name:HAMID ALI
Last Name:SALEH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:BELAL
Other - Middle Name:H
Other - Last Name:SALEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7601 SOUTHCREST PKWY
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-4739
Practice Address - Country:US
Practice Address - Phone:877-348-1281
Practice Address - Fax:901-227-3206
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-16812207R00000X
MI5101022237207R00000X
MS31724207R00000X
TN3664207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101022237OtherOSTEOPATHIC MEDICINE & SURGERY EDUCATION LIMITED LICENSE PERMANENT ID#