Healthcare Provider Details

I. General information

NPI: 1407111081
Provider Name (Legal Business Name): HESHAM Z. SALEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 10/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 HEART DR EAST CAROLINA HEART INSTITUTE- CARDIOTHORACIC SURGERY
GREENVILLE NC
27834-8944
US

IV. Provider business mailing address

PO BOX 751069
CHARLOTTE NC
28275-1069
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-4400
  • Fax: 252-744-3987
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number2012-01103
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: