Provider Demographics
NPI:1245636356
Name:BHUIYA, MATIUR RAHMAN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MATIUR
Middle Name:RAHMAN
Last Name:BHUIYA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E EDGEWOOD BLVD APT 8
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-5808
Mailing Address - Country:US
Mailing Address - Phone:260-312-8905
Mailing Address - Fax:
Practice Address - Street 1:2125 S MISSION ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-4426
Practice Address - Country:US
Practice Address - Phone:989-773-6991
Practice Address - Fax:989-779-8091
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020408721835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy