NPI 1124054556

Rezwan Islam, MD

Practitioner Family Medicine Physician Fulton, MO

Practice location

Address: 850 N Hospital Dr STE D, Fulton, MO 65251-2535
Phone: (573) 642-5338
Fax: (573) 642-9224
Mailing address: 850 N Hospital Dr STE F, Fulton, MO 65251-2535

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 2004010833 (MO)

Other Family Medicine providers in Missouri →

Registry record

NPI: 1124054556
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jun 2006
Record last updated: 9 Aug 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.