Basic Information
Provider Information
NPI: 1912934290
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SALHAB
FirstName: MAHMOUD
MiddleName: H.
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 READS WAY
Address2: STE. 201
City: NEW CASTLE
State: DE
PostalCode: 197201630
CountryCode: US
TelephoneNumber: 3027094709
FaxNumber: 3027094551
Practice Location
Address1: 4755 OGLETOWN STANTON ROAD
Address2:  
City: NEWARK
State: DE
PostalCode: 197181320
CountryCode: US
TelephoneNumber: 3027331000
FaxNumber: 3027332685
Other Information
ProviderEnumerationDate: 06/26/2006
LastUpdateDate: 05/20/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XL60A00289DEN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000XL6-0A00289DEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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