Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | 0101246900 | VA |
N | 2080P0202X | Pediatric Cardiologist | D0040310 | MD |
NPI | 1164467288 |
---|---|
Provider Name | Dr. Mubadda A Salim |
First Address | Baltimore, MD 21227-1019 |
Second Address | Baltimore, MD 21227-1019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 08/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164467288 | (05) | VA |
161461400 | (05) | MD |
F89193 | (02) |