Healthcare Provider Details

I. General information

NPI: 1780983528
Provider Name (Legal Business Name): WAEL SALEM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 E MOUNTAIN VIEW RD STE 201
SCOTTSDALE AZ
85258-4424
US

IV. Provider business mailing address

8901 E MOUNTAIN VIEW RD STE 201
SCOTTSDALE AZ
85258-4424
US

V. Phone/Fax

Practice location:
  • Phone: 480-237-2043
  • Fax: 520-462-2292
Mailing address:
  • Phone: 480-237-2043
  • Fax: 520-462-2292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number125618
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number69062
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number64179
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: