Provider Demographics
NPI:1861566598
Name:SALEH, MOHAMED GALAL (MD,DC)
Entity type:Individual
Prefix:
First Name:MOHAMED
Middle Name:GALAL
Last Name:SALEH
Suffix:
Gender:M
Credentials:MD,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-0365
Mailing Address - Country:US
Mailing Address - Phone:248-629-7497
Mailing Address - Fax:248-397-8474
Practice Address - Street 1:624 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-1842
Practice Address - Country:US
Practice Address - Phone:248-629-7497
Practice Address - Fax:248-394-8474
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008526111N00000X
MI43011005712083A0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractor
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Single Specialty