Provider Demographics
NPI:1053450460
Name:SALAHIE, SIMA (MD)
Entity type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:SALAHIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27450 SCHOENHERR RD STE 500
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6679
Mailing Address - Country:US
Mailing Address - Phone:586-582-7632
Mailing Address - Fax:586-582-7633
Practice Address - Street 1:27450 SCHOENHERR RD STE 500
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6679
Practice Address - Country:US
Practice Address - Phone:586-582-7632
Practice Address - Fax:586-582-7633
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107098208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010407010Medicaid
VAQ77770Medicare UPIN
VA010407010Medicaid