MEDICARE: DR. AHMED SAMMY RASHWAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	C53530	CA
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	01085372A	IN
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	C53530	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	118045	OTHER	MO	STATE MEDICAL LICENSE
2	036101038	OTHER	IL	STATE MEDICAL LICENSE
3	35083809	OTHER	OH	STATE MEDICAL LICENSE
4	9901298	OTHER	NC	STATE MEDICAL LICENSE
5	C53530	OTHER	CA	STATE MEDICAL LICENSE
6	549584	OTHER	CA	AMERICAN BOARD OF INTERNAL MEDICINE

General Provider Information

NPI Number	:	1487688412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMED SAMMY RASHWAN M.D.

Provider Business Mailing Address
First Line	:	301 E DAY RD
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-3455
Country	:	US
Telephone Number	:	406-327-3100
Fax Number	:	406-327-2141

Provider Business Practice Location Address
First Line	:	900 N ORANGE ST STE 106
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-2951
Country	:	US
Telephone Number	:	406-327-3100
Fax Number	:	406-327-2141

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/19/2021

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Directions to “ DR. AHMED SAMMY RASHWAN M.D.” Practice Location

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