Healthcare Provider Details

I. General information

NPI: 1225790538
Provider Name (Legal Business Name): MR. MUEEZ REHMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date: 05/06/2024
Reactivation Date: 05/21/2024

III. Provider practice location address

1300 N 12TH ST
PHOENIX AZ
85006-2848
US

IV. Provider business mailing address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

V. Phone/Fax

Practice location:
  • Phone: 602-839-3927
  • Fax:
Mailing address:
  • Phone: 505-272-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR80964
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: