Provider Demographics
NPI:1083759641
Name:ALAM, MUHAMMAD SHAH (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:SHAH
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2926 PITKIN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-3422
Mailing Address - Country:US
Mailing Address - Phone:718-647-4724
Mailing Address - Fax:718-647-6061
Practice Address - Street 1:2926 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-3422
Practice Address - Country:US
Practice Address - Phone:718-647-4724
Practice Address - Fax:718-647-6061
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228414208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics