Provider Demographics
NPI:1609342724
Name:SALAM, RAHMA (PA - STUDENT)
Entity type:Individual
Prefix:
First Name:RAHMA
Middle Name:
Last Name:SALAM
Suffix:
Gender:F
Credentials:PA - STUDENT
Other - Prefix:
Other - First Name:RAHMA
Other - Middle Name:
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2839 SHANANDALE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1636
Mailing Address - Country:US
Mailing Address - Phone:301-379-5221
Mailing Address - Fax:
Practice Address - Street 1:8206 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4519
Practice Address - Country:US
Practice Address - Phone:301-960-4682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0007443363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant