Healthcare Provider Details

I. General information

NPI: 1336704220
Provider Name (Legal Business Name): YOUSEF MOHAMMAD ABU-SALHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2019
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 KILDAIRE PARK DR STE 500
CARY NC
27518-8164
US

IV. Provider business mailing address

121 MANORDALE DR
CHAPEL HILL NC
27517-9622
US

V. Phone/Fax

Practice location:
  • Phone: 919-467-3203
  • Fax:
Mailing address:
  • Phone: 919-610-9348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number2024-01262
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: