MEDICARE: NAILA T 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	207R00000X	Internal Medicine Physician	0101050403	VA

General Provider Information

NPI Number	:	1902422587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAILA T RAHMAN

Provider Business Mailing Address
First Line	:	5416 3RD ST S
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-1114
Country	:	US
Telephone Number	:	571-338-2252
Fax Number	:

Provider Business Practice Location Address
First Line	:	5416 3RD ST S
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-1114
Country	:	US
Telephone Number	:	571-338-2252
Fax Number	:

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

Provider Enumeration Date	:	06/19/2020
Last Update Date	:	06/19/2020

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