Healthcare Provider Details

I. General information

NPI: 1750049185
Provider Name (Legal Business Name): RAHI VICTORY MD, FACOG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 TWIN OAKS DRIVE
WINDSOR ONTARIO
N8N 5C2
CA

IV. Provider business mailing address

8100 TWIN OAKS DRIVE
WINDSOR ONTARIO
N8N 5C2
CA

V. Phone/Fax

Practice location:
  • Phone: 519-944-6400
  • Fax: 519-944-6406
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number4301081370
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: