Nizam, Mohammed Soubhi

Nizam, Mohammed Soubhi is an individual health care provider with primary practice located at 1055 N 500 W Ste 205 , Provo UT 84604-3305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Nizam, Mohammed Soubhi can be contacted via phone (801) 429-8095.

Contact Information

Primary practice address
1055 N 500 W Ste 205 Provo UT 84604-3305
Phone: (801) 429-8095
Fax: (801) 354-8265
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 6955621-1205 Utah

Profile Details

NPI number 1326203514
LBN Legal business name Nizam, Mohammed Soubhi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2008
Last updated Nov 27th, 2023 - about 2 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 1326203514 NPPES
Indiana Other 000000705030 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 201013750 ANTHEM PROVIDER NUMBER

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