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General NPI Number Information
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NPI Number | 1396702916
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Entity Type | Organization
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Legal Business Name | REHABILITATION MEDICINE SERVICES PC
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 04/13/2010
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Provider Practice Location Address
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Address Line | 1914 MEETING CT
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City | WILMINGTON
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State | NC
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Zip | 28401-6631
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Country | US
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Telephone | 910-362-1112
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Fax | 910-362-1115
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Provider Business Mailing Address
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Address Line | PO BOX 7217
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City | WILMINGTON
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State | NC
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Zip | 28406
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Country | US
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Telephone | 910-362-1112
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Fax | 910-362-1115
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Authorized Official
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Title or Position | PRESIDENT
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Name | AFSHIN TAMADON
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Credential | MD
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Telephone | 910-362-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 27487
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 9800403
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License Number State | NC
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Legacy Identifiers
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Identifier #1
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Identifier Code | 274875
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Identifier Type | MEDICAID
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Identifier State | SC
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Identifier Issuer |
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Identifier #2
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Identifier Code | 790287F
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Identifier Type | MEDICAID
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Identifier State | NC
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 274875
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Identifier Type | MEDICAID
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Identifier State | SC
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Identifier Issuer |
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Identifier #2
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Identifier Code | 790287F
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Identifier Type | MEDICAID
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Identifier State | NC
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Identifier Issuer |
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