Physician Compare National (NPI:1215948872)

HEALTHCARE PROVIDER: ANWARUL ISLAM MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1215948872
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991861254
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090311000645
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ISLAM
	Individual professional last name
Provider First Name	ANWARUL
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	637 KINGSBOROUGH SQ B
	Group Practice or individual's line 1 address
City	CHESAPEAKE
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	233204944
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490120
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHESAPEAKE REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490007
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SENTARA NORFOLK GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	490046
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SENTARA LEIGH HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y