MEDICARE: AMARA SALAAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	208100000X	Physical Medicine & Rehabilitation Physician	LPT-33122	AZ

General Provider Information

NPI Number	:	1033892989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARA SALAAM

Provider Business Mailing Address
First Line	:	521 S 3RD ST STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2757
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 S 3RD ST STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2757
Country	:	US
Telephone Number	:	623-295-1109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	02/10/2026

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Directions to “ AMARA SALAAM ” Practice Location

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