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NPI Code Detail

MEDICARE: RAQUIBUL ISLAM M.D.

MEDICARE: RAQUIBUL ISLAM M.D.
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
1207R00000XInternal Medicine PhysicianMD062423LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174577035
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAQUIBUL ISLAM M.D.
Provider Business Mailing Address
First Line : 2600 W 9TH ST
Second Line : 2 NORTH
City : CHESTER
State : PA
Zip : 19013-2040
Country : US
Telephone Number : 610-485-3800
Fax Number : 610-485-4221
Provider Business Practice Location Address
First Line : 125 E 9TH ST
Second Line :
City : CHESTER
State : PA
Zip : 19013-6019
Country : US
Telephone Number : 671-872-6131
Fax Number : 610-872-5128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 07/29/2013

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Directions to “ RAQUIBUL ISLAM M.D.” Practice Location

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