Provider Demographics
NPI:1720293285
Name:BHUIYAN, MOHAMMED BADIUL ALAM (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:BADIUL ALAM
Last Name:BHUIYAN
Suffix:
Gender:M
Credentials:MD, MPH
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Other - First Name:
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Mailing Address - Street 1:1201 BROAD ROCK BLVD # D
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-1553
Mailing Address - Country:US
Mailing Address - Phone:804-675-5455
Mailing Address - Fax:048-675-5223
Practice Address - Street 1:1201 BROAD ROCK BLVD # D
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-1553
Practice Address - Country:US
Practice Address - Phone:804-675-5455
Practice Address - Fax:804-675-5223
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238424207Q00000X, 2081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1720293285Medicaid
VA00X6027Q02Medicare PIN