Provider Demographics
NPI:1407334519
Name:SALLAM, TARIQ T A (MD)
Entity type:Individual
Prefix:
First Name:TARIQ
Middle Name:T A
Last Name:SALLAM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2211 LOMAS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2719
Mailing Address - Country:US
Mailing Address - Phone:505-272-2111
Mailing Address - Fax:
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2719
Practice Address - Country:US
Practice Address - Phone:505-272-2111
Practice Address - Fax:202-877-6292
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2025-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2025-0285207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease