Shan Ul Islam, Syed Muhammad

Shan Ul Islam, Syed Muhammad is an individual health care provider with primary practice located at 1331 State St , La Porte IN 46350-3112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Shan Ul Islam, Syed Muhammad can be contacted via phone (219) 326-1775.

Contact Information

Primary practice address
1331 State St La Porte IN 46350-3112
Phone: (219) 326-1775
Fax: (219) 326-1951
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 19490 Mississippi
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01070169A Indiana

Profile Details

NPI number 1487742896
LBN Legal business name Shan Ul Islam, Syed Muhammad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Dec 13th, 2021 - about 4 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 1487742896 NPPES
Mississippi MEDICAID 05388729
Mississippi Other M400055273
Mississippi Other 151020025
Mississippi Other P01003687
Mississippi MEDICAID 201034600

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