MEDICARE: DR. HASSEN A SALEH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301097280	MI

General Provider Information

NPI Number	:	1295017051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HASSEN A SALEH MD

Provider Business Mailing Address
First Line	:	3270 GREENFIELD RD
Second Line	:
City	:	BERKLEY
State	:	MI
Zip	:	48072-1161
Country	:	US
Telephone Number	:	248-268-1525
Fax Number	:	248-268-1523

Provider Business Practice Location Address
First Line	:	3270 GREENFIELD RD
Second Line	:
City	:	BERKLEY
State	:	MI
Zip	:	48072-1161
Country	:	US
Telephone Number	:	248-268-1525
Fax Number	:	248-268-1523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2011
Last Update Date	:	02/10/2020

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