DR. ELLIS J SALLOUM (NPI# 1871540088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871540088 |
Entity Type | Individual |
Full Name | DR. ELLIS J SALLOUM |
Other Name | DR. ELLIS J SALLOUM |
Credential | M.D. |
Practice Address |
1225 Campbell Way Ste 101 Bremerton WA 98310 |
Mailing Address |
13401 River Rapid Dr Diberville MS 39540-8827 |
Practice Telephone | 3604794203 |
Practice Fax Number | 3604787240 |
Mailing Telephone | 3342946953 |
Enumeration Date | 2006-05-31 |
Last Update Date | 2020-10-20 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD60941287 | WA | Allopathic & Osteopathic Physicians |
N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
36455 | AL | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
2055 E South Blvd Ste 908, Montgomery, AL 361162007 | 3342846500 | 3342846202 |
Street Address |
1225 CAMPBELL WAY STE 101 |
City | BREMERTON |
State | WA |
Zip Code | 98310 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639141658 | George Henry Meier | Surgery | 1225 Campbell Way Ste 101, Bremerton, WA 98310-3323 | 2006-02-03 |
1275001612 | Aljade R Rosario | Nurse Practitioner | 1225 Campbell Way Ste 101, Bremerton, WA 98310 | 2018-11-04 |
1922297001 | James Leroy Hardy | Physician Assistant | 1225 Campbell Way Ste 101, Bremerton, WA 98310-3323 | 2007-10-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891333613 | Miss Mary Community Development | Voluntary or Charitable | 1630 Trenton Avenue Apt 10, Bremerton, WA 98310 | 2019-12-11 |
1629636055 | Puget Sound Work Injury Clinic, LLC | Clinic/Center | 812 Cherry Ct, Bremerton, WA 98310 | 2019-05-31 |
1538672530 | Rachel E Mittelstaedt Parsons | Dietitian, Registered | 3059 Viewcrest Dr Ne, Bremerton, WA 98310 | 2017-11-13 |
1356888937 | Sarah Hike | Community Health Worker | 900 Sheridan, Bremerton, WA 98310 | 2017-01-20 |
1073941142 | Hana Singer | Physical Therapy Assistant | 3600 Forest Dr Ne, Bremerton, WA 98310 | 2013-10-28 |
1447508122 | Kevin Lee Hathaway | Mechanotherapist | 3308 Veska Avenue, Bremerton, WA 98310 | 2012-08-28 |
1003163007 | James Hyun Soo Lee | Surgery | Cvn 76 Uss Ronald Reagan, Bremerton, WA 98310 | 2012-08-08 |
1487936241 | Karen S Casseday | Nurse Practitioner | 1740 Ne Riddell Rd Ste 110, Bremerton, WA 98310 | 2011-09-16 |
1740560572 | Lauren P Foresman | Physician Assistant | 2709 Hemlock Street, Bremerton, WA 98310 | 2011-08-24 |
1538390059 | Patricia L Rushon | Speech-Language Pathologist | 560 Lebo Blvd., Bremerton, WA 98310 | 2009-07-31 |
Find all providers in zip 98310 |
Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013104165 | John S Arthur | Surgery | 2528 Wheaton Way Ste 101, Bremerton, WA 98310-3305 | 2007-10-02 |
1639141658 | George Henry Meier | Surgery | 1225 Campbell Way Ste 101, Bremerton, WA 98310-3323 | 2006-02-03 |
1831190040 | George A Berni | Surgery | 1225 Campbell Way, Ste 101, Bremerton, WA 98310-3351 | 2005-08-10 |
1336386473 | Franciscan Medical Group | Surgery | 1225 Campbell Way, Suite 101, Bremerton, WA 98310-3351 | 2009-01-12 |
1629016522 | Thoracic & Vascular Center of Kitsap County Inc Ps | Surgery | 1225 Campbell Way, Suite 101, Bremerton, WA 98310-3351 | 2006-06-03 |
1043202450 | Mark C Adams | Surgery | 1225 Campbell Way, Suite 101, Bremerton, WA 98310-3351 | 2005-08-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710496922 | Sunnyside Community Hospital Association | Surgery | 1005 W Walnut St Ste 201, Yakima, WA 98902-3384 | 2017-09-20 |
1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
1356722938 | Usa Vascular Centers of Kent Pllc | Surgery | 26124a Pacific Hwy S Ste A, Kent, WA 98032-6910 | 2015-06-09 |
1154602084 | Memorial Physicians, Pllc | Surgery | 1812 E Edison Ave, Sunnyside, WA 98944-1653 | 2011-09-06 |
1528387941 | Sara Jane Wasilenko | Surgery | 128 Lilly Rd Ne Ste 205, Olympia, WA 98506-7400 | 2010-05-25 |
1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
1649491481 | Dae Young Lee | Surgery | 1100 Goethals Drive 3rd Floor, Kadlec Clinic Vascular Surgery, Richland, WA 99352-3304 | 2007-05-01 |
1497975361 | Rolando I Celis Valdiviezo | Surgery | 1330 Rockefeller Ave Ste 520, Everett, WA 98201 | 2007-04-26 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.