MEDICARE: ATTIYA SALIM M.D.

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	14991	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073510673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATTIYA SALIM M.D.

Provider Business Mailing Address
First Line	:	945 GARDENCREST DR
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86409-2912
Country	:	US
Telephone Number	:	928-757-5522
Fax Number	:	928-692-2591

Provider Business Practice Location Address
First Line	:	945 GARDENCREST DR
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86409-2912
Country	:	US
Telephone Number	:	928-757-5522
Fax Number	:	928-692-2591

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	12/27/2021

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