MEDICARE: MOHAMMED NAZMUL 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	207R00000X	Internal Medicine Physician	0101234152	VA
2	207R00000X	Internal Medicine Physician	52504	MN
3	207RN0300X	Nephrology Physician	MD44650	IA
4	207RN0300X	Nephrology Physician	28458	NE

General Provider Information

NPI Number	:	1659351328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMED NAZMUL MD

Provider Business Mailing Address
First Line	:	7710 MERCY RD STE 426
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68124-2323
Country	:	US
Telephone Number	:	402-343-8650
Fax Number	:	402-343-8545

Provider Business Practice Location Address
First Line	:	7710 MERCY RD STE 426
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68124-2323
Country	:	US
Telephone Number	:	402-343-8650
Fax Number	:	402-343-8545

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	07/26/2021

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