Individual
SHAHEEN UL ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-8623
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(706) 721-3928
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35.086587
OH
207RP1001X
Pulmonary Disease Physician
Primary
080189
GA
207RP1001X
Pulmonary Disease Physician
35.086587
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2588945
—
OH
Enumeration date
02/02/2006
Last updated
06/27/2018
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