Healthcare Provider Details

I. General information

NPI: 1831399542
Provider Name (Legal Business Name): IFAD U RAHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2936 N ELM ST STE 102
LUMBERTON NC
28358-2981
US

IV. Provider business mailing address

815 OAKRIDGE BLVD
LUMBERTON NC
28358-2330
US

V. Phone/Fax

Practice location:
  • Phone: 910-671-6619
  • Fax: 910-608-0487
Mailing address:
  • Phone: 919-737-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number50708
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2020-04140
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL30128
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: