=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639326705
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AKHIL UR RAHMAN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2008
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12033 AGENCY RD
-----------------------------------------------------
City | PARKER
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85344-7718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-669-2137
-----------------------------------------------------
Fax | 928-669-3131
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 MARTIN LUTHER KING JR BLVD S APT # D 114
-----------------------------------------------------
City | PONTIAC
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48341-2900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-499-3586
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 4301091959
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------