Individual
DR. ISLAM MOHAMED SHATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 793-2695
(401) 444-4165
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 793-2695
(401) 444-4165
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-46397
KS
207RC0000X
Cardiovascular Disease Physician
Primary
MD20593
RI
390200000X
Student in an Organized Health Care Education/Training Program
2019018926
MO
Other
Enumeration date
07/01/2019
Last updated
07/30/2025
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