Basic Information
Provider Information
NPI: 1336704220
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABU-SALHA
FirstName: YOUSEF
MiddleName: MOHAMMAD
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5016 DILLSWOOD LN
Address2:  
City: RALEIGH
State: NC
PostalCode: 276064271
CountryCode: US
TelephoneNumber: 9196109348
FaxNumber:  
Practice Location
Address1: 101 MANNING DR
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275144220
CountryCode: US
TelephoneNumber: 9849741315
FaxNumber: 9849745289
Other Information
ProviderEnumerationDate: 05/06/2019
LastUpdateDate: 05/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X248864NCY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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