Organization
LESLIE JOHN SALLOUM, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LESLIE JOHN SALLOUM MD (PRESIDENT)
(910) 417-3540
Entity
Organization
Contact information
Practice address
921 S LONG DR, SUITE 208, ROCKINGHAM, NC 28379-4874
(910) 417-3540
(910) 417-3542
Mailing address
921 S LONG DR, SUITE 208, ROCKINGHAM, NC 28379-4874
(910) 417-3540
(910) 417-3542
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
200301519
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13506
BCBS
—
05
—
8913506
—
NC
01
—
DC2516
RR MEDICARE
—
Enumeration date
07/25/2006
Last updated
10/02/2008
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