Healthcare Provider Details

I. General information

NPI: 1013129865
Provider Name (Legal Business Name): SALEM N MAALIKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 9TH AVE NW
WATERTOWN SD
57201-1548
US

IV. Provider business mailing address

1000 E WASHINGTON ST
MEDINA OH
44256-2170
US

V. Phone/Fax

Practice location:
  • Phone: 605-882-7953
  • Fax: 605-882-7954
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number173791
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number12837878-1235
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number7356
License Number StateSD
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number12837878-1235
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: