Provider Demographics
NPI:1225052442
Name:RAHMAN, ADEEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEEL
Middle Name:
Last Name:RAHMAN
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:PO BOX 846
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-0846
Mailing Address - Country:US
Mailing Address - Phone:770-267-1159
Mailing Address - Fax:770-267-1163
Practice Address - Street 1:513 GREAT OAKS DRIVE STE. B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655
Practice Address - Country:US
Practice Address - Phone:770-267-1159
Practice Address - Fax:770-267-1163
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0506702084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA400988329AMedicaid
GA400988329AMedicaid
I43312Medicare UPIN