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Individual

DR. MOHAMMAD KAMRUL ISLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1871 N ELM ST, COMMERCE, GA 30529-2349
(706) 659-3540
(706) 659-3541
Mailing address
2964 SILVERMERE LANE, DULUTH, GA 30097
(678) 439-1393
(706) 659-3541

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2133
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
856421474A
GA
05
856421474B
GA
05
856421474C
GA
Enumeration date
10/02/2006
Last updated
10/12/2021
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