Healthcare Provider Details

I. General information

NPI: 1699420224
Provider Name (Legal Business Name): DUAA ALI SALEH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 S TELEGRAPH RD
DEARBORN HEIGHTS MI
48125-1929
US

IV. Provider business mailing address

3925 S TELEGRAPH RD
DEARBORN HEIGHTS MI
48125-1929
US

V. Phone/Fax

Practice location:
  • Phone: 313-768-5446
  • Fax:
Mailing address:
  • Phone: 313-768-5446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601011291
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: