Healthcare Provider Details

I. General information

NPI: 1235163221
Provider Name (Legal Business Name): PAIN MANAGEMENT AND REHABILITATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 RESEARCH CT STE 625
SUWANEE GA
30024-6608
US

IV. Provider business mailing address

5120 TOWN CENTER BLVD
PEACHTREE CORNERS GA
30092-2761
US

V. Phone/Fax

Practice location:
  • Phone: 770-288-3311
  • Fax: 770-288-3824
Mailing address:
  • Phone: 770-288-3311
  • Fax: 770-288-3824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number054116
License Number StateGA

VIII. Authorized Official

Name: DR. KHALIQUE U. REHMAN
Title or Position: PHYSICIAN
Credential: MD
Phone: 770-288-3311