Provider Demographics
NPI:1801026752
Name:SALAMA, AHMED MOHAMED (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:MOHAMED
Last Name:SALAMA
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 1:15500 LUNDY PKWY
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2778
Mailing Address - Country:US
Mailing Address - Phone:313-586-5011
Mailing Address - Fax:313-792-7134
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-982-5819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA193697207PT0002X
MI4301097021207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine