Provider Demographics
NPI:1124680178
Name:SALEM, ADAM AMIN (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:AMIN
Last Name:SALEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 LANGDON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2750
Mailing Address - Country:US
Mailing Address - Phone:606-451-5092
Mailing Address - Fax:
Practice Address - Street 1:303 LANGDON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2750
Practice Address - Country:US
Practice Address - Phone:606-451-5092
Practice Address - Fax:606-451-5087
Is Sole Proprietor?:No
Enumeration Date:2019-06-30
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43-51045171390200000X
KY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program