Provider Demographics
NPI:1134253867
Name:NOOR, SALMAN AHMAD (MD)
Entity type:Individual
Prefix:
First Name:SALMAN
Middle Name:AHMAD
Last Name:NOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 76TH ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1984
Mailing Address - Country:US
Mailing Address - Phone:262-577-8300
Mailing Address - Fax:262-577-8414
Practice Address - Street 1:9555 76TH ST
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-1984
Practice Address - Country:US
Practice Address - Phone:262-577-8300
Practice Address - Fax:262-577-8414
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50864-20207R00000X, 207RI0200X
IL036.125849207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1134253867Medicaid
WI322500134OtherMEDICARE (WI)
CA00A865830OtherMEDI CAL