Individual
SULEMAN ILYAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 457-3336
(401) 525-2549
Mailing address
593 EDDY STREET, PROVIDENCE, RI 02903-4923
(401) 457-3336
(401) 525-2549
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LP04789
RI
207R00000X
Internal Medicine Physician
MT217986
PA
Other
Enumeration date
06/03/2019
Last updated
05/12/2020
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