MEDICARE: DR. GOHAR A SALAM M.D., F.A.C.S.

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	207W00000X	Ophthalmology Physician	01058885A	IN
2	261QA1903X	Ambulatory Surgical Clinic/Center	130127411	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7800696	OTHER	IN	AETNA
2	000000364631	OTHER	IN	ANTHEM
3	17842	OTHER	IN	PHP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285635334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GOHAR A SALAM M.D., F.A.C.S.

Provider Business Mailing Address
First Line	:	11188 DIEBOLD RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-9662
Country	:	US
Telephone Number	:	260-483-9500
Fax Number	:	260-483-9511

Provider Business Practice Location Address
First Line	:	11188 DIEBOLD RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-9662
Country	:	US
Telephone Number	:	260-483-9500
Fax Number	:	260-483-9511

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	03/02/2016

Similar Medicare Providers

1457492167 — RETINA INSTITUTE OF INDIANA, P.C.
Practice Location Address:

11188 DIEBOLD RD
FORT WAYNE, IN
46845-9662

Practice Phone: 260-483-9500
Practice Fax: 260-483-9511

1841510294 — DR. ADEEL N KHAN M.D.
Practice Location Address:

11188 DIEBOLD RD
FORT WAYNE, IN
46845-9662

Practice Phone: 260-483-9500
Practice Fax: 260-483-9511

1730442559 — RETINA INSTITUTE OF INDIANA SURGERY CENTER, LLC
Practice Location Address:

11192 DIEBOLD RD
FORT WAYNE, IN
46845-9662

Practice Phone: 260-483-9500
Practice Fax: 260-483-9511

1578494274 — ASHLEE DENAE RISING PT, DPT
Practice Location Address:

3731 W COOK RD
FORT WAYNE, IN
46818-9662

Practice Phone: 260-297-4545
Practice Fax:

1558753541 — ARUN NAIDU P.T.
Practice Location Address:

3731 W COOK RD
FORT WAYNE, IN
46818-9662

Practice Phone: 260-490-2112
Practice Fax:

1447839709 — FRANCISCA OPOKU
Practice Location Address:

3731 W COOK RD
FORT WAYNE, IN
46818-9662

Practice Phone: 260-490-2112
Practice Fax:

Directions to “ DR. GOHAR A SALAM M.D., F.A.C.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.