Individual
DR. REZWAN ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 N HOSPITAL DR, STE D, FULTON, MO 65251-2535
(573) 642-5338
(573) 642-9224
Mailing address
850 N HOSPITAL DR, STE F, FULTON, MO 65251-2535
(573) 642-5338
(573) 642-9224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004010833
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207313107
—
MO
Enumeration date
06/25/2006
Last updated
08/09/2013
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