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NPI Code Detail

MEDICARE: DR. MAHBUB MOHAMMAD BHUIYAN MD

MEDICARE: DR. MAHBUB MOHAMMAD BHUIYAN 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
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianP114784NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P114784OTHERLIMITED PERMIT TO PRACTICE MEDICINE

General Provider Information

NPI Number : 1497497176
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAHBUB MOHAMMAD BHUIYAN MD
Provider Business Mailing Address
First Line : 1990 GOLFVIEW DR APT 205
Second Line :
City : TROY
State : MI
Zip : 48084-3838
Country : US
Telephone Number : 248-835-6958
Fax Number :
Provider Business Practice Location Address
First Line : 6 MEDICAL PLZ
Second Line :
City : GLEN COVE
State : NY
Zip : 11542-2108
Country : US
Telephone Number : 631-742-9081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2022
Last Update Date : 04/12/2022

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