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1306548961

NPI Code Detail

MEDICARE: DR. SHAHEEN M RAHMAN MD

MEDICARE: DR. SHAHEEN M RAHMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	4301517296	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4301517296	OTHER	MI	MI LICENSE

General Provider Information

NPI Number	:	1306548961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAHEEN M RAHMAN MD

Provider Business Mailing Address
First Line	:	1700 S 23RD ST
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4803
Country	:	US
Telephone Number	:	772-773-2963
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 S 23RD ST
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34950-4803
Country	:	US
Telephone Number	:	772-773-2963
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	05/04/2026

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Directions to “ DR. SHAHEEN M RAHMAN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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