Provider Demographics
NPI:1467464495
Name:ZAMAN, MOHAMMAD KHALEQUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:KHALEQUZ
Last Name:ZAMAN
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 1:95 MESHANTICUT VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-3929
Mailing Address - Country:US
Mailing Address - Phone:401-946-8400
Mailing Address - Fax:401-944-7219
Practice Address - Street 1:105 SOCKANOSSET RD
Practice Address - Street 2:SUITE # 322
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-946-8400
Practice Address - Fax:401-944-7219
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD 100992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry