Healthcare Provider Details

I. General information

NPI: 1841306958
Provider Name (Legal Business Name): BASHAR SALEM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25200 CENTER RIDGE RD SUITE 3400
WESTLAKE OH
44145-4141
US

IV. Provider business mailing address

24500 CENTER RIDGE RD STE 375
WESTLAKE OH
44145-5631
US

V. Phone/Fax

Practice location:
  • Phone: 440-331-4646
  • Fax: 440-331-3197
Mailing address:
  • Phone: 440-895-5056
  • Fax: 440-333-2935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35.094841
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.094841
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: