Provider Demographics
NPI:1750376562
Name:SALEEM, GULRUKH (MD)
Entity type:Individual
Prefix:DR
First Name:GULRUKH
Middle Name:
Last Name:SALEEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GULRUKH
Other - Middle Name:
Other - Last Name:SYED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 17334
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1334
Mailing Address - Country:US
Mailing Address - Phone:703-443-6717
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:19465 DEERFIELD AVE STE 309
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-1705
Practice Address - Country:US
Practice Address - Phone:703-723-3398
Practice Address - Fax:703-723-9128
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068304207RR0500X
VA0101232354207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1750376562Medicaid
VA1750376562Medicaid
VAVV1988BMedicare PIN
MDI45611Medicare UPIN
00X147M01Medicare PIN