Provider Demographics
NPI:1922205079
Name:ZAKY SALAMA, WADID YOUSSEF (MD)
Entity type:Individual
Prefix:
First Name:WADID
Middle Name:YOUSSEF
Last Name:ZAKY SALAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10231 OLD OCEAN CITY BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3568
Mailing Address - Country:US
Mailing Address - Phone:240-616-6006
Mailing Address - Fax:240-616-2828
Practice Address - Street 1:10231 OLD OCEAN CITY BLVD STE 208
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-3568
Practice Address - Country:US
Practice Address - Phone:240-616-6006
Practice Address - Fax:240-616-2828
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252883207LP2900X
NC2016-00023207LP2900X
DEC1-0012391207LP2900X
MA232877207R00000X
MDD74778207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1922205079Medicaid