MEDICARE: AMIR RAHMAN

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	363A00000X	Physician Assistant	5601014036	MI

General Provider Information

NPI Number	:	1659259893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIR RAHMAN

Provider Business Mailing Address
First Line	:	3611 CARPENTER ST STE 5
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48212-2784
Country	:	US
Telephone Number	:	313-733-8286
Fax Number	:	313-826-0899

Provider Business Practice Location Address
First Line	:	3611 CARPENTER ST STE 5
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48212-2784
Country	:	US
Telephone Number	:	313-733-8286
Fax Number	:

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

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	05/30/2026

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Directions to “ AMIR RAHMAN ” Practice Location

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