Basic Information
Provider Information
NPI: 1073046538
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALAN
FirstName: SHEINEI
MiddleName: SALEEM
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SALEEM
OtherFirstName: SHEINEI
OtherMiddleName: JAMAL
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 37174
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212973174
CountryCode: US
TelephoneNumber: 5714235699
FaxNumber: 5714235698
Practice Location
Address1: 3300 GALLOWS RD
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220423300
CountryCode: US
TelephoneNumber: 7037764001
FaxNumber: 7037767113
Other Information
ProviderEnumerationDate: 04/11/2017
LastUpdateDate: 03/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0101267363VAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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