Individual
REZAUL ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 FORSYTHE AVE, MONROE, LA 71201-3014
(318) 699-0505
(318) 699-0506
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(318) 699-0505
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
12313R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1542377
—
LA
Enumeration date
06/02/2006
Last updated
04/22/2022
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