Healthcare Provider Details

I. General information

NPI: 1508211913
Provider Name (Legal Business Name): OMAR RAHEEM SALEEM D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 E STATE ST
SHARON PA
16146-3328
US

IV. Provider business mailing address

12351 PERRY HWY
WEXFORD PA
15090-8344
US

V. Phone/Fax

Practice location:
  • Phone: 724-983-3911
  • Fax:
Mailing address:
  • Phone: 412-359-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS019822
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS019822
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: