Healthcare Provider Details

I. General information

NPI: 1932695541
Provider Name (Legal Business Name): MAHMOUD SALEM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 15TH ST STE 310
GREELEY CO
80631-4562
US

IV. Provider business mailing address

1800 15TH ST STE 310
GREELEY CO
80631-4562
US

V. Phone/Fax

Practice location:
  • Phone: 970-810-0900
  • Fax:
Mailing address:
  • Phone: 970-810-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberDR.0077939
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: