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General NPI Number Information
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NPI Number | 1629207477
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Entity Type | Individual
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Provider Name | ELSAYED SALEM ABO-SALEM MD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 11125 DUNN RD STE 204
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6188
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Country | US
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Telephone | 314-839-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 3635 VISTA AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63110-2539
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Country | US
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Telephone | 314-268-7992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 35129185
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 036143069
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 2016023781
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License Number State | MO
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