Provider Demographics
NPI:1396265971
Name:SALAH, MOHAMED HASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:HASSAN
Last Name:SALAH
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 1:2725 SW 187TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2441
Mailing Address - Country:US
Mailing Address - Phone:856-366-5949
Mailing Address - Fax:
Practice Address - Street 1:12741 MIRAMAR PKWY STE 302
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2905
Practice Address - Country:US
Practice Address - Phone:954-602-9723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.071410207V00000X
IL036.153742207V00000X
NJ25MA11180600207V00000X
FLME149878207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology