Provider Demographics
NPI:1255786711
Name:SALEEM, SHIRAZ (DO)
Entity type:Individual
Prefix:
First Name:SHIRAZ
Middle Name:
Last Name:SALEEM
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 1:1101 MARKET ST
Mailing Address - Street 2:FL 30
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-2934
Mailing Address - Country:US
Mailing Address - Phone:215-503-3685
Mailing Address - Fax:
Practice Address - Street 1:501 MADISON AVENUE
Practice Address - Street 2:THE WRIGHT CENTER
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510
Practice Address - Country:US
Practice Address - Phone:570-343-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS021439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine