Provider Demographics
NPI:1639195456
Name:SALEH, MOHAMMAD (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:SALEH
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 1:1637 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2912
Mailing Address - Country:US
Mailing Address - Phone:313-757-0157
Mailing Address - Fax:313-757-7495
Practice Address - Street 1:1637 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2912
Practice Address - Country:US
Practice Address - Phone:313-757-0157
Practice Address - Fax:313-757-7495
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068003207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMS068003OtherBCBS OF MICHIGAN
MI4425912Medicaid
MIMS068003OtherBLUECARE NETWORK
MIMS068003OtherBCBS OF MICHIGAN
MIG19180Medicare UPIN