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General NPI Number Information
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NPI Number | 1992146179
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Entity Type | Individual
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Provider Name | ANIS REHMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2013
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 14908 JEFFERSON DAVIS HWY
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City | WOODBRIDGE
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State | VA
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Zip | 22191-4016
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Country | US
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Telephone | 330-999-1907
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Fax | 703-214-9773
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Provider Business Mailing Address
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Address Line | PO BOX 19654
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City | SPRINGFIELD
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State | IL
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Zip | 62794-9654
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Country | US
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Telephone | 217-545-8000
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Fax | 217-545-1229
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 57.022448
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 036-144964
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License Number State | IL
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