Individual
MOHAMMAD ISLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1272 W MAIN ST STE 503, NEWARK, OH 43055-2058
(220) 564-1805
(220) 564-1806
Mailing address
1320 W MAIN ST, NEWARK, OH 43055-1822
(220) 564-4027
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
35.145446
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2016
Last updated
12/09/2022
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