Basic Information
| Provider Information | |||||||||
| NPI: | 1912279977 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALIM | ||||||||
| FirstName: | SHAKEEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D, M.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 EVES DR # A | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MARLTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080533195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092679400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 994 W SHERMAN AVE | ||||||||
| Address2: | BUILDING 1 | ||||||||
| City: | VINELAND | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 083606937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566960900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2012 | ||||||||
| LastUpdateDate: | 04/07/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081S0010X | MD444614 | PA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Sports Medicine | 2081P2900X | 25MA09272600 | NJ | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 208100000X | 25MA09272600 | NJ | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.