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: 05/21/2024
Certification Date: 08/23/2022
Deactivation Date: 05/06/2024
Reactivation Date: 05/21/2024

III. Provider practice location address

MSC 09 5085, 1 UNIVERSITY OF NEW MEXICO
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-4766
  • Fax:
Mailing address:
  • Phone: 505-272-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: