Healthcare Provider Details

I. General information

NPI: 1306100805
Provider Name (Legal Business Name): SHEIKH ABDUL SALAM SALEEM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 CENTRAL EXPY N STE 210
ALLEN TX
75013-6102
US

IV. Provider business mailing address

5112 WEST TAFT ROAD SUITE H
LIVERPOOL NY
13088
US

V. Phone/Fax

Practice location:
  • Phone: 972-747-6043
  • Fax: 972-747-6476
Mailing address:
  • Phone: 315-452-3235
  • Fax: 315-410-7490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberU7508
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number280710
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberU7508
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: