MEDICARE: MERVET K SALEH 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	35-050248	OH

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356414957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERVET K SALEH M.D.

Provider Business Mailing Address
First Line	:	1235 E. ALEX BELL ROAD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459
Country	:	US
Telephone Number	:	937-435-6400
Fax Number	:	937-435-4793

Provider Business Practice Location Address
First Line	:	1235 E ALEX BELL RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-2658
Country	:	US
Telephone Number	:	937-435-6400
Fax Number	:	937-435-4793

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	01/10/2013

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