MEDICARE: MUHAMMAD SHAH ALAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	228414	NY

General Provider Information

NPI Number	:	1083759641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUHAMMAD SHAH ALAM MD

Provider Business Mailing Address
First Line	:	2926 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-3422
Country	:	US
Telephone Number	:	718-647-4724
Fax Number	:	718-647-6061

Provider Business Practice Location Address
First Line	:	2926 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-3422
Country	:	US
Telephone Number	:	718-647-4724
Fax Number	:	718-647-6061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	03/22/2012

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