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Individual

DR. NIGEL ISLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3700 WASHINGTON AVE, EVANSVILLE, IN 47714-0541
(812) 485-7040
Mailing address
PO BOX 13059, BELFAST, ME 04915-4021

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01050897A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000373088
ANTHEM PROVIDER#
IN
05
100180890G
IN
05
200331220
IN
01
CH6490
GROUP # IN RAILROAD
IN
01
P00266485
IN RAILROAD MCR#
IN
Enumeration date
06/08/2006
Last updated
01/03/2018
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