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General NPI Number Information
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NPI Number | 1487742896
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Entity Type | Individual
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Provider Name | SYED MUHAMMAD SHAN UL ISLAM MD
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 960 JOE FRANK HARRIS PKWY SE
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2129
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Country | US
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Telephone | 470-490-2142
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Fax |
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Provider Business Mailing Address
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Address Line | 2022 KELLE DR
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City | CHESTERTON
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State | IN
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Zip | 46304-8708
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Country | US
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Telephone | 219-364-4004
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Fax | 219-326-2584
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 85117
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01070169A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19490
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 85117
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License Number State | GA
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