Provider Demographics
NPI:1225173941
Name:RAHN, MICHAEL L (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:RAHN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 9422
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-9422
Mailing Address - Country:US
Mailing Address - Phone:703-475-4144
Mailing Address - Fax:
Practice Address - Street 1:7912 FALSTAFF RD
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-2727
Practice Address - Country:US
Practice Address - Phone:703-475-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO267213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC021255400Medicaid
MD6020585Medicaid
MD6020585Medicaid
47826Medicare ID - Type Unspecified