Individual
MAHMOUD A SALEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(800) 968-6866
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036093369
IL
207P00000X
Emergency Medicine Physician
108467
MO
207R00000X
Internal Medicine Physician
036093369
IL
207R00000X
Internal Medicine Physician
108467
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204666804
—
MO
05
—
204666812
—
MO
05
—
204666838
—
MO
05
—
204666846
—
MO
Enumeration date
11/22/2005
Last updated
03/09/2022
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