Healthcare Provider Details

I. General information

NPI: 1164843207
Provider Name (Legal Business Name): ZIYAD MOHAMMED S BINSALAMAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 CONGRESS ST
PORTLAND ME
04102-3112
US

IV. Provider business mailing address

818 CONGRESS ST
PORTLAND ME
04102-3112
US

V. Phone/Fax

Practice location:
  • Phone: 207-773-8161
  • Fax:
Mailing address:
  • Phone: 207-773-8161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberB524910108007
License Number StateZZ
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberP8858
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD27664
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: