Healthcare Provider Details

I. General information

NPI: 1255694451
Provider Name (Legal Business Name): MOHAMMAD SUHAIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 OLD RIVER RD. SUITE 108
LINCOLN RI
02865-1397
US

IV. Provider business mailing address

132 OLD RIVER RD. SUITE 108
LINCOLN RI
02865-1397
US

V. Phone/Fax

Practice location:
  • Phone: 401-723-9250
  • Fax: 401-334-1054
Mailing address:
  • Phone: 401-723-9250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD15056
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: