Healthcare Provider Details

I. General information

NPI: 1699769307
Provider Name (Legal Business Name): ABDELAZIZ A SALEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11123 PARKVIEW PLAZA DR STE 205
FORT WAYNE IN
46845-1707
US

IV. Provider business mailing address

1 PERKINS SQ
AKRON OH
44308-1063
US

V. Phone/Fax

Practice location:
  • Phone: 260-425-6650
  • Fax: 260-672-6519
Mailing address:
  • Phone: 330-543-4500
  • Fax: 330-543-4508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number01097016A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number036076214
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number93818
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number35086215
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: