Healthcare Provider Details

I. General information

NPI: 1063472561
Provider Name (Legal Business Name): SYED M RAHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 11/30/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W COUNTRY CLUB RD RADIATION ONCOLOGY
ROSWELL NM
88201-5209
US

IV. Provider business mailing address

250 KAWAIHAE ST APT 8B
HONOLULU HI
96825-1951
US

V. Phone/Fax

Practice location:
  • Phone: 575-624-8738
  • Fax:
Mailing address:
  • Phone: 614-432-4384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35041603R
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD2014-0858
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: