Healthcare Provider Details

I. General information

NPI: 1750731717
Provider Name (Legal Business Name): SALEH ALI BUSBAIT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KING FAISAL RD
DAMMAM KSA
34221
SA

IV. Provider business mailing address

KING FAISAL RD
DAMAM KSA
34221
SA

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number4301513161
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: