Healthcare Provider Details
I. General information
NPI: 1033271382
Provider Name (Legal Business Name): TARIQ REHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/14/2006
Last Update Date: 01/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4141A DUKE ST
ALEXANDRIA VA
22304-2415
US
IV. Provider business mailing address
4915 AUBURN AVE STE 200
BETHESDA MD
20814-2636
US
V. Phone/Fax
- Phone: 703-461-3556
- Fax: 703-461-8075
- Phone: 304-526-2532
- Fax: 304-526-4542
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | 0101253736 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: