Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 157042 | MA |
N | 208000000X | Pediatrician | 157042 | MA |
N | 2080P0201X | Pediatric Allergist | 157042 | MA |
NPI | 1992846984 |
---|---|
Provider Name | Dr. Sadek Salloum |
First Address | Cambridge, MA 02138-3316 |
Second Address | Cambridge, MA 02138-3316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2007 |
Last Update Date | 08/07/2007 |