Healthcare Provider Details

I. General information

NPI: 1205827615
Provider Name (Legal Business Name): SYED A REHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 JAHNKE RD SUITE 611
RICHMOND VA
23225-4017
US

IV. Provider business mailing address

7101 JAHNKE RD SUITE 611
RICHMOND VA
23225-4017
US

V. Phone/Fax

Practice location:
  • Phone: 804-327-4046
  • Fax: 804-327-4047
Mailing address:
  • Phone: 804-327-4046
  • Fax: 804-327-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101235075
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: