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General NPI Number Information
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NPI Number | 1871687590
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Entity Type | Individual
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Provider Name | SHAMIM M ISLAM MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1001 MAIN ST FL 4
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City | BUFFALO
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State | NY
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Zip | 14203-1009
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Country | US
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Telephone | 716-323-0150
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Fax | 716-323-0296
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Provider Business Mailing Address
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Address Line | 1001 MAIN ST FL 5
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City | BUFFALO
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State | NY
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Zip | 14203-1009
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Country | US
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Telephone | 716-323-0150
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Fax | 716-323-0296
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 277439
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 1971464
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A86834
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License Number State | CA
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