Healthcare Provider Details

I. General information

NPI: 1841847035
Provider Name (Legal Business Name): NAWAL SALAHUDDIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10299 SOUTHERN BLVD # 212773
ROYAL PALM BEACH FL
33411-4337
US

IV. Provider business mailing address

10299 SOUTHERN BLVD # 212773
ROYAL PALM BEACH FL
33411-4337
US

V. Phone/Fax

Practice location:
  • Phone: 305-735-2452
  • Fax:
Mailing address:
  • Phone: 53-735-2452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number19496
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number59415
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: