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Individual

DR. MOHAMMED ISMAIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1300 MASSACHUSETTS AVE, TROY, NY 12180-1628
(518) 268-5542
Mailing address
46 THIRD ST, WATERFORD, NY 12188
(518) 237-0641
(518) 235-6401

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
119154
NY
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
119154
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
119154
NY
207RP1001X
Pulmonary Disease Physician
119154
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00540372
NY
Enumeration date
07/12/2006
Last updated
01/20/2020
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