Provider Demographics
NPI:1053970640
Name:ABDELSALAM, MAHMOUD GOUDA ABDELRAHMAN
Entity type:Individual
Prefix:
First Name:MAHMOUD
Middle Name:GOUDA ABDELRAHMAN
Last Name:ABDELSALAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MACCORKLE AVE SE STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1215
Mailing Address - Country:US
Mailing Address - Phone:304-388-8200
Mailing Address - Fax:304-388-7087
Practice Address - Street 1:6550 FANNIN ST STE 1801
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2744
Practice Address - Country:US
Practice Address - Phone:346-238-0115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program