Provider Demographics
NPI:1841395282
Name:SALEME, MAURICIO NAIM (MD)
Entity Type:Individual
Prefix:DR
First Name:MAURICIO
Middle Name:NAIM
Last Name:SALEME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4190
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-4190
Mailing Address - Country:US
Mailing Address - Phone:304-399-4405
Mailing Address - Fax:304-399-2526
Practice Address - Street 1:2828 1ST AVE STE 205
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1236
Practice Address - Country:US
Practice Address - Phone:304-399-7290
Practice Address - Fax:304-399-7291
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV11330208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV127725000Medicaid
KY64694276Medicaid
WV0127725000Medicaid
OH3141540Medicaid
SA0438133Medicare ID - Type Unspecified
WV0438135Medicare PIN
OH3141540Medicaid