Provider Demographics
NPI:1992865166
Name:SALAH, HANY SAMIR (DO)
Entity Type:Individual
Prefix:DR
First Name:HANY
Middle Name:SAMIR
Last Name:SALAH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 COPPERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5310
Mailing Address - Country:US
Mailing Address - Phone:703-904-0842
Mailing Address - Fax:
Practice Address - Street 1:12222 MERIT DR STE 600
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3294
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102050103207L00000X
DCMD30801207L00000X
WV1711207L00000X
OH8191207L00000X
NJMB061288207L00000X
MDH0051867207L00000X
TXS9989207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA103990OtherANTHEM VA
MDP00417574OtherRAILROAD MEDICARE PTAN
VA103990OtherANTHEM VA
VAG49262Medicare UPIN