Healthcare Provider Details

I. General information

NPI: 1033103908
Provider Name (Legal Business Name): ALI R RAHIMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 LINKSIDE LAKE DR
RICHMOND HILL GA
31324-1195
US

IV. Provider business mailing address

249 LINKSIDE LAKE DR
RICHMOND HILL GA
31324-1195
US

V. Phone/Fax

Practice location:
  • Phone: 912-856-5269
  • Fax: 844-674-8545
Mailing address:
  • Phone: 912-856-5269
  • Fax: 844-674-8545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number110214
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: