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NPI Code Detail

MEDICARE: DR. TAHIRAH ABDUR RAHMAN DO

MEDICARE: DR. TAHIRAH ABDUR RAHMAN DO
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
1207R00000XInternal Medicine PhysicianOS017153PA
2207R00000XInternal Medicine Physician34.011577OH
3207R00000XInternal Medicine Physician008588AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477843316
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAHIRAH ABDUR RAHMAN DO
Provider Business Mailing Address
First Line : 7500 N DREAMY DRAW DR STE 145
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-4668
Country : US
Telephone Number : 480-882-4545
Fax Number : 480-882-5814
Provider Business Practice Location Address
First Line : 4131 N 24TH ST STE B102
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-6231
Country : US
Telephone Number : 480-882-4545
Fax Number : 602-381-1341
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2011
Last Update Date : 12/30/2022

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