MEDICARE: DR. MOHAMMAD SALEEM CSA

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	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1689916355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD SALEEM CSA

Provider Business Mailing Address
First Line	:	16355 EAGLE FLIGHT CIR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-6081
Country	:	US
Telephone Number	:	703-507-8968
Fax Number	:

Provider Business Practice Location Address
First Line	:	16355 EAGLE FLIGHT CIR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-6081
Country	:	US
Telephone Number	:	703-507-8968
Fax Number	:

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

Provider Enumeration Date	:	03/20/2013
Last Update Date	:	03/20/2013

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