MEDICARE: TIPU FAIZ MUHAMMED SALEEM MD

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	23268	WV
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MD072815L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	073454	OTHER	WV	MEDICARE ID TYPE UNPECIFIED

Other Identifiers

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

General Provider Information

NPI Number	:	1215934609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIPU FAIZ MUHAMMED SALEEM MD

Provider Business Mailing Address
First Line	:	1575 HIGHLANDS DR
Second Line	:	SUITE 206
City	:	LITITZ
State	:	PA
Zip	:	17543-7507
Country	:	US
Telephone Number	:	717-568-8886
Fax Number	:	717-627-2727

Provider Business Practice Location Address
First Line	:	1575 HIGHLANDS DR
Second Line	:	SUITE 206
City	:	LITITZ
State	:	PA
Zip	:	17543-7507
Country	:	US
Telephone Number	:	717-568-8886
Fax Number	:	717-627-2727

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	09/28/2016

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Directions to “ TIPU FAIZ MUHAMMED SALEEM MD” Practice Location

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