Provider Demographics
NPI:1902500390
Name:ALAM, MOHAMMED SHAFIUL (MBBS, MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:SHAFIUL
Last Name:ALAM
Suffix:
Gender:M
Credentials:MBBS, MD
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6136 170TH ST APT M4
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1957
Mailing Address - Country:US
Mailing Address - Phone:917-582-7278
Mailing Address - Fax:516-441-6768
Practice Address - Street 1:7810 164TH ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1229
Practice Address - Country:US
Practice Address - Phone:718-709-0940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP120824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine