Individual
DR. BASMAN ABDEL SALOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6913 N MAIN ST STE 300, GRANGER, IN 46530-8039
(574) 647-1500
(574) 243-4310
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01043104A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085201
BCBS BMG MAIN STREET
IN
01
—
000000085202
BCBS BMG IRELAND RD MED POINT
IN
01
—
000000111141
BCBS BMG PORTAGE RD
IN
01
—
000000195021
BCBS BMG E BLAIR WARNER
IN
01
—
000000314664
BCBS BMG IRELAND RD
IN
05
—
200042370
—
IN
Enumeration date
11/29/2005
Last updated
05/01/2023
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