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Individual

MOHAMMED N. ISLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1265 WAYNE AVE, 119 PROF. BLDG, SUITE 103, INDIANA, PA 15701-3501
(724) 463-1046
(724) 463-2314
Mailing address
9 NORTH 7TH STREET, SUITE 203, INDIANA, PA 15701-1880
(724) 357-7196
(724) 357-7279

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD436442
PA
2086S0129X
Vascular Surgery Physician
195804
NY
2086S0129X
Vascular Surgery Physician
Primary
MD436442
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01663309
NY
Enumeration date
09/20/2006
Last updated
08/23/2011
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