Provider Demographics
NPI:1952346504
Name:SALEEM, JAVAID (MD)
Entity Type:Individual
Prefix:
First Name:JAVAID
Middle Name:
Last Name:SALEEM
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 1:3300 OAKDALE AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2926
Mailing Address - Country:US
Mailing Address - Phone:763-520-5200
Mailing Address - Fax:
Practice Address - Street 1:12000 ELM CREEK BLVD N
Practice Address - Street 2:SUITE 130
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7073
Practice Address - Country:US
Practice Address - Phone:763-581-5800
Practice Address - Fax:763-581-5801
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN41525207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN150273OtherUCARE #
MNDA9071022999OtherPREFERRED ONE #
MN0106099OtherMEDICA #
MN71D04SAOtherMNBS #
MN053769100Medicaid
MNHP37592OtherHEALTHPARTNERS #
NDND100055OtherLHS #
MN11104Medicaid
MN18591OtherNDBS #
MN909831OtherAMERICA'S PPO/ARAZ #
MN18591OtherNDBS #
MNDA9071022999OtherPREFERRED ONE #
NDND100055OtherLHS #