Healthcare Provider Details

I. General information

NPI: 1730617986
Provider Name (Legal Business Name): FHEZA SALEEM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 EXECUTIVE BLVD 625
BETHESDA MD
20852
US

IV. Provider business mailing address

14310 WICKLOW LN
LAUREL MD
20707-6886
US

V. Phone/Fax

Practice location:
  • Phone: 240-314-7080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD90216
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number86529
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: