MEDICARE: MOHAMMED SAIFUL ISLAM

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	183500000X	Pharmacist	5302035943	MI

General Provider Information

NPI Number	:	1245973353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMED SAIFUL ISLAM

Provider Business Mailing Address
First Line	:	987 BANWELL RD
Second Line	:
City	:	WINDSOR
State	:	ONTARIO
Zip	:	N8P 1J3
Country	:	CA
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 E STATE ST
Second Line	:
City	:	CASSOPOLIS
State	:	MI
Zip	:	49031-1328
Country	:	US
Telephone Number	:	269-445-5369
Fax Number	:	269-445-5369

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

Provider Enumeration Date	:	04/16/2022
Last Update Date	:	04/16/2022

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Directions to “ MOHAMMED SAIFUL ISLAM ” Practice Location

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