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General NPI Number Information
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NPI Number | 1780709923
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Entity Type | Organization
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Legal Business Name | M N SALEME SURGERY INC
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2828 FIRST AVE SUITE 205
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City | HUNTINGTON
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State | WV
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Zip | 25702
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Country | US
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Telephone | 304-522-7046
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Fax | 304-522-6297
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Provider Business Mailing Address
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Address Line | 2828 FIRST AVE SUITE 205
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City | HUNTINGTON
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State | WV
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Zip | 25702
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Country | US
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Telephone | 304-522-7046
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Fax | 304-522-6297
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Authorized Official
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Title or Position | PRESIDENT MN SALEME SURGERY INC
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Name | DR. MAURICIO NAIM SALEME
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Credential | MD
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Telephone | 304-522-7046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 11330
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License Number State | WV
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