Provider Demographics
NPI:1508291279
Name:ISLAM, MOHAMMED Z (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:Z
Last Name:ISLAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MD
Other - Middle Name:ZAKIUL
Other - Last Name:ISLAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6643
Mailing Address - Fax:484-526-4658
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-6643
Practice Address - Fax:484-526-4658
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127358207Q00000X
NY301540207Q00000X
PAMD468673207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018018200Medicaid