Islam, Mohammad

Islam, Mohammad is an individual health care provider with primary practice located at 107 Newtown Rd 2C, Danbury CT 06810-4146. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Islam, Mohammad can be contacted via phone (203) 791-9661.

Contact Information

Primary practice address
107 Newtown Rd 2C Danbury CT 06810-4146
Phone: (203) 791-9661
Fax: (203) 730-4165
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 038143 Connecticut
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 038143 Connecticut

Profile Details

NPI number 1811992878
LBN Legal business name Islam, Mohammad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Mar 1st, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811992878 NPPES
Connecticut MEDICAID 001381433

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