1255367157 NPI number — OBAID REHMAN MD

Table of content: OBAID REHMAN MD (NPI 1255367157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255367157 NPI number — OBAID REHMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REHMAN
Provider First Name:
OBAID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255367157
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
340 HODGSON CT
Provider Second Line Business Mailing Address:
SUITE #2
Provider Business Mailing Address City Name:
SAVANNAH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31406-1520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-927-6270
Provider Business Mailing Address Fax Number:
912-927-6254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11700 MERCY BLVD
Provider Second Line Business Practice Location Address:
BLDG #5
Provider Business Practice Location Address City Name:
SAVANNAH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31419-1753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-927-6270
Provider Business Practice Location Address Fax Number:
912-927-6254
Provider Enumeration Date:
06/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RS0012X , with the licence number:  044990 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: 044990 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0200X , with the licence number: 044990 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000788818L , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00322250 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: G44990 . This is a "SOUTH CAROLINA MEDICAID" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 102055300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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