Individual
SYED MUHAMMAD SHAN UL ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
960 JOE FRANK HARRIS PKWY SE, CARTERSVILLE, GA 30120-2129
(470) 490-2142
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-4004
(219) 326-2584
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01070169A
IN
207R00000X
Internal Medicine Physician
19490
MS
207R00000X
Internal Medicine Physician
Primary
85117
GA
208M00000X
Hospitalist Physician
85117
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05388729
—
MS
01
—
151020025
MEDICARE PTAN
IN
05
—
201034600
—
IN
01
—
M400055273
MEDICARE PTAN
IN
01
—
P01003687
RAILROAD MEDICARE PTAN
IN
Enumeration date
10/11/2006
Last updated
11/20/2025
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