Provider Demographics
NPI:1982068912
Name:NOURELDINE, SALEM (MD)
Entity Type:Individual
Prefix:
First Name:SALEM
Middle Name:
Last Name:NOURELDINE
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 1:1201 N GARFIELD ST APT 406
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-6810
Mailing Address - Country:US
Mailing Address - Phone:901-550-3352
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # G2-230B
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-3201
Practice Address - Country:US
Practice Address - Phone:216-445-9096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD20000070208600000X
390200000X
OH35.140973208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program