Provider Demographics
NPI:1043738552
Name:RAHMAN, RAZUR (RPH)
Entity Type:Individual
Prefix:
First Name:RAZUR
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24599 ACORN TRAIL
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30050 HOOVER RD STE G
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2544
Practice Address - Country:US
Practice Address - Phone:586-578-9621
Practice Address - Fax:586-578-9613
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049673183500000X
MI5302032124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist