=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184846974
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHEIKH RAHMAN, M.D INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/03/2007
-----------------------------------------------------
Last Update Date | 10/21/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 276 BIELBY RD
-----------------------------------------------------
City | LAWRENCEBURG
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47025-2787
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-537-0344
-----------------------------------------------------
Fax | 812-537-5027
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 276 BIELBY RD
-----------------------------------------------------
City | LAWRENCEBURG
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47025-2787
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-537-0344
-----------------------------------------------------
Fax | 812-537-5027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SHEIKH A RAHMAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 812-537-0344
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 01028332B
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------