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Individual

DR. MOHAMMAD ISLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
107 NEWTOWN RD, 2C, DANBURY, CT 06810-4146
(203) 791-9661
(203) 730-4165
Mailing address
107 NEWTOWN RD, 2C, DANBURY, CT 06810-4146
(203) 791-9661
(203) 730-4165

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
038143
CT
208200000X
Plastic Surgery Physician
Primary
038143
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001381433
CT
Enumeration date
06/16/2005
Last updated
03/01/2018
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