Provider Demographics
NPI:1922365881
Name:SALEEM, MOHAMMED (PT)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:
Last Name:SALEEM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 MAPLE PARK DR E
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-4827
Mailing Address - Country:US
Mailing Address - Phone:734-771-9860
Mailing Address - Fax:
Practice Address - Street 1:1807 MAPLE PARK DR E
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-4827
Practice Address - Country:US
Practice Address - Phone:734-771-9860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist