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General NPI Number Information
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NPI Number | 1871273938
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Entity Type | Individual
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Provider Name | SALIM SHEIK MOHAMUD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 6808 UNIVERSITY AVE STE 108
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City | MIDDLETON
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State | WI
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Zip | 53562-2779
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Country | US
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Telephone | 614-589-8807
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Fax |
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Provider Business Mailing Address
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Address Line | 6808 UNIVERSITY AVE STE 108
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City | MIDDLETON
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State | WI
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Zip | 53562-2779
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Country | US
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Telephone | 614-589-8807
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | M5307979426703
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License Number State | WI
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