Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Mohammed Soubhi Nizam, MD

Individual provider Endocrinology, Diabetes & Metabolism Physician · NPI 1326203514

Dr. Mohammed Soubhi Nizam, MD is an Endocrinology in Provo, Utah. Qualified in 1988, 38 years ago. Practices with Revere Health PC, a 410-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
38
Licensed in
UT
In the registry since
2008
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1055 N 500 W Ste 205
Provo, UT 84604-3305
Phone: (801) 429-8095
Fax: (801) 354-8265
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1175 E 50 S Ste 241, American Fork, UT 84003-2849 — (801) 429-8095

Specialties & licences

Endocrinology, Diabetes & Metabolism Physician (primary) Taxonomy 207RE0101X · Licence 6955621-1205 (UT)

Record details

NPI number1326203514
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 28, 2008
Last updated in NPPESNovember 27, 2023
Certification dateMarch 17, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyENDOCRINOLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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