Basic Information
| Provider Information | |||||||||
| NPI: | 1366880106 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALEEM | ||||||||
| FirstName: | ASMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 608 NW 9TH STREET, SUITE 1000 | ||||||||
| Address2: | ST. ANTHONY PHYSICIAN GROUP FAMILY MEDICINE CENTER | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052727494 | ||||||||
| FaxNumber: | 4052726985 | ||||||||
| Practice Location | |||||||||
| Address1: | 608 NW 9TH STREET | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052727494 | ||||||||
| FaxNumber: | 4052726985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2013 | ||||||||
| LastUpdateDate: | 07/29/2016 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 04/03/2014 | ||||||||
| NPIReactivationDate: | 04/23/2014 | ||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 29970 | OK | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207VX0000X | 29970 | OK | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
No ID Information.