Provider Demographics
NPI:1144592197
Name:N. REHMATULLAH, MD, INC
Entity Type:Organization
Organization Name:N. REHMATULLAH, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NASIMULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:REHMATULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-593-6433
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-0219
Mailing Address - Country:US
Mailing Address - Phone:440-593-6433
Mailing Address - Fax:440-593-6900
Practice Address - Street 1:167 W MAIN RD
Practice Address - Street 2:SUITE C
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2057
Practice Address - Country:US
Practice Address - Phone:440-593-6433
Practice Address - Fax:440-593-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH45903207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0457189Medicaid
OH0457189Medicaid