Mohamed, Ahmed Salem

Mohamed, Ahmed Salem is an sole proprietor health care provider with primary practice located at 412 S 34Th St Ste 101 , Mount Vernon IL 62864-6021. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Mohamed, Ahmed Salem can be contacted via phone (618) 231-6121.

Contact Information

Primary practice address
412 S 34Th St Ste 101 Mount Vernon IL 62864-6021
Fax: (618) 615-4380
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Other Service Providers / Specialist 174400000X 036136254 Illinois

Profile Details

NPI number 1053633461
LBN Legal business name Mohamed, Ahmed Salem
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2010
Last updated Dec 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053633461 NPPES
Illinois MEDICAID 036136254

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