Healthcare Provider Details

I. General information

NPI: 1174453211
Provider Name (Legal Business Name): RUMYAH MAHMUDA RAFIQUE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

IV. Provider business mailing address

5181 TRAILWOOD LN
WARREN MI
48092-2399
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-1735
  • Fax:
Mailing address:
  • Phone: 313-258-8539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMT236901
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: