Provider Demographics
NPI:1184657645
Name:REHMAN, ATIQ UR (MD)
Entity Type:Individual
Prefix:
First Name:ATIQ
Middle Name:UR
Last Name:REHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 GROVE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-796-9200
Mailing Address - Fax:856-796-9397
Practice Address - Street 1:1 BRACE RD
Practice Address - Street 2:SUITE C
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2600
Practice Address - Country:US
Practice Address - Phone:856-470-9029
Practice Address - Fax:856-428-4053
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.135723208G00000X
NJ25MA09579300208G00000X
MS18134208G00000X
FLME85549208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0438880Medicaid
NJ0438880Medicaid
H93963Medicare UPIN
MS07505595Medicaid
P00127962Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MS780000052Medicare ID - Type Unspecified