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NPI Code Detail

MEDICARE: NAHRAIN RAIHAN MD

MEDICARE: NAHRAIN RAIHAN 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
1390200000XStudent in an Organized Health Care Education/Training Program
22084P0804XChild & Adolescent Psychiatry Physician74320WI
32084P0800XPsychiatry Physician74320WI

General Provider Information

NPI Number : 1952753337
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAHRAIN RAIHAN MD
Provider Business Mailing Address
First Line : 1501 KINGS HWY
Second Line :
City : SHREVEPORT
State : LA
Zip : 71103-4228
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4600 W SCHROEDER DR
Second Line :
City : BROWN DEER
State : WI
Zip : 53223-6458
Country : US
Telephone Number : 800-767-4411
Fax Number : 262-646-3158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2016
Last Update Date : 05/14/2021

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