MEDICARE: DR. MATIUR RAHMAN BHUIYA PHARM 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
1	1835P1200X	Pharmacotherapy Pharmacist	5302040872	MI

General Provider Information

NPI Number	:	1245636356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATIUR RAHMAN BHUIYA PHARM D

Provider Business Mailing Address
First Line	:	301 E EDGEWOOD BLVD APT 8
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48911-5808
Country	:	US
Telephone Number	:	260-312-8905
Fax Number	:

Provider Business Practice Location Address
First Line	:	2125 S MISSION ST
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-4426
Country	:	US
Telephone Number	:	989-773-6991
Fax Number	:	989-779-8091

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

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	11/17/2014

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