Nizam, Abdul R,

Nizam, Abdul R, is an sole proprietor health care provider with primary practice located at 630 N Morley St Ste 101, Moberly MO 65270-2556. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Suppliers / Eyewear Supplier (Equipment, not the service). Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Nizam, Abdul R, can be contacted via phone (660) 263-0404.

Contact Information

Primary practice address
630 N Morley St Ste 101 Moberly MO 65270-2556
Phone: (660) 263-0404
Fax: (660) 263-1725
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 113224 Missouri
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X 113224 Missouri

Profile Details

NPI number 1568465359
LBN Legal business name Nizam, Abdul R,
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated Feb 7th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568465359 NPPES
Missouri MEDICAID 325927507
Missouri Other 238605
Missouri MEDICAID 209988542

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