Basic Information
| Provider Information | |||||||||
| NPI: | 1801026752 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALAMA | ||||||||
| FirstName: | AHMED | ||||||||
| MiddleName: | MOHAMED | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15500 LUNDY PKWY | ||||||||
| Address2: | |||||||||
| City: | DEARBORN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481262778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3135865011 | ||||||||
| FaxNumber: | 3137927134 | ||||||||
| Practice Location | |||||||||
| Address1: | 18101 OAKWOOD BLVD | ||||||||
| Address2: | |||||||||
| City: | DEARBORN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481244089 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139825819 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2009 | ||||||||
| LastUpdateDate: | 03/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PT0002X | 193697 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Medical Toxicology | 207R00000X | 4301097021 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.