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General NPI Number Information
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NPI Number | 1548248297
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Entity Type | Individual
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Provider Name | MAHMOOD RAHMAN MD
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Gender | Male
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 76 FORDWAY DR. STE 2
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City | VANDALIA
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State | OH
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Zip | 45377
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Country | US
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Telephone | 937-890-3139
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Fax | 937-890-3111
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Provider Business Mailing Address
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Address Line | 76 FORDWAY DR. STE 2
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City | VANDALIA
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State | OH
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Zip | 45377
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Country | US
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Telephone | 937-890-3139
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Fax | 937-890-3111
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35066692R
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License Number State | OH
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