Healthcare Provider Details

I. General information

NPI: 1225715204
Provider Name (Legal Business Name): DR. MOHAMMAD SAAD SALAM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST # HQ101
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

800 ROSE ST # HQ101
LEXINGTON KY
40536-7001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-7058
  • Fax:
Mailing address:
  • Phone: 859-323-7058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4351049781
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: