MEDICARE: DR. MOHAMMAD REZA RAHNAMA 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	207R00000X	Internal Medicine Physician	D0045475	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110118499	OTHER	MD	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E268-0002	OTHER	MD	FEDERAL BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	53440804	OTHER	MD	BLUE SHEILD OF MD
5	552987	OTHER	MD	AETNA PLANS

General Provider Information

NPI Number	:	1952458739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD REZA RAHNAMA MD

Provider Business Mailing Address
First Line	:	9512 HARFORD RD
Second Line	:	SUITE 4
City	:	PARKVILLE
State	:	MD
Zip	:	21234-3100
Country	:	US
Telephone Number	:	410-665-4400
Fax Number	:	410-661-2420

Provider Business Practice Location Address
First Line	:	9512 HARFORD RD STE 4
Second Line	:
City	:	PARKVILLE
State	:	MD
Zip	:	21234-3127
Country	:	US
Telephone Number	:	410-665-4400
Fax Number	:	410-661-2420

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	02/23/2022

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