Healthcare Provider Details

I. General information

NPI: 1669175493
Provider Name (Legal Business Name): SALMAAN MOHAMMED MUBEEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PATERSON STREET, SUITE 7300
NEW BRUNSWICK NJ
08901
US

IV. Provider business mailing address

8416 GOVERNOR BRADFORD LN
ELLICOTT CITY MD
21043
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-8887
  • Fax:
Mailing address:
  • Phone: 443-716-6275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0105998
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: