Basic Information
Provider Information
NPI: 1538323332
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHALOUHI
FirstName: SALAM
MiddleName: EDWARD
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 933 BRADBURY DR SE STE 2222
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871064375
CountryCode: US
TelephoneNumber: 5052723120
FaxNumber: 5052728060
Practice Location
Address1: 2211 LOMAS BLVD NE FL 4
Address2: AMBULATORY CARE CTR
City: ALBUQUERQUE
State: NM
PostalCode: 871062719
CountryCode: US
TelephoneNumber: 5052722245
FaxNumber: 5052721109
Other Information
ProviderEnumerationDate: 07/11/2008
LastUpdateDate: 06/28/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMD2012-0008NMY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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