Provider Demographics
NPI:1922072263
Name:HADRAMI, SALAM O (MD)
Entity Type:Individual
Prefix:DR
First Name:SALAM
Middle Name:O
Last Name:HADRAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1147 INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5545
Mailing Address - Country:US
Mailing Address - Phone:757-460-1207
Mailing Address - Fax:757-460-2136
Practice Address - Street 1:450 NORTHSIDE CHEROKEE BLVD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8015
Practice Address - Country:US
Practice Address - Phone:770-224-1000
Practice Address - Fax:770-224-2451
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101232732207R00000X
GA051468208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101232732OtherVIRGINIA MEDICAL LICENSE
VABH7607154OtherDEA
VAH62864Medicare UPIN
VABH7607154OtherDEA