MEDICARE: DR. RIZWANA YASMIN RAHMAN D.O.

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	207Q00000X	Family Medicine Physician	5101020398	MI

General Provider Information

NPI Number	:	1457693327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RIZWANA YASMIN RAHMAN D.O.

Provider Business Mailing Address
First Line	:	30795 TWENTY-THREE MILE ROAD
Second Line	:	SUITE 205
City	:	CHESTERFIELD TOWNSHIP
State	:	MI
Zip	:	48047
Country	:	US
Telephone Number	:	586-421-3150
Fax Number	:	586-421-3151

Provider Business Practice Location Address
First Line	:	30795 TWENTY-THREE MILE ROAD
Second Line	:	SUITE 205
City	:	CHESTERFIELD TOWNSHIP
State	:	MI
Zip	:	48047
Country	:	US
Telephone Number	:	586-421-3150
Fax Number	:	586-421-3151

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

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	01/30/2017

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