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General NPI Number Information
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NPI Number | 1841350899
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Entity Type | Organization
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Legal Business Name | SALAM PSYCHIATRIC SERVICES, P.L.C
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 20 TECHNOLOGY DRIVE # 9
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City | BRATTLEBORO
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State | VT
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Zip | 05301
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Country | US
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Telephone | 802-246-0781
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Fax | 802-246-0742
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Provider Business Mailing Address
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Address Line | 20 TECHNOLOGY DRI # 9
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City | BRATTLEBORO
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State | VT
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Zip | 05301
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Country | US
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Telephone | 802-246-0781
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Fax | 802-246-0742
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SABA MAHEEN SALAM
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Credential | M.D.
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Telephone | 802-246-0781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 42-0010331
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License Number State | VT
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