Provider Demographics
NPI:1265851091
Name:ANSARI, RASHID MOIN (MD)
Entity Type:Individual
Prefix:
First Name:RASHID
Middle Name:MOIN
Last Name:ANSARI
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 1:625 19TH STREET SOUTH
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35249
Mailing Address - Country:US
Mailing Address - Phone:256-551-4631
Mailing Address - Fax:
Practice Address - Street 1:773 STOCKBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-7200
Practice Address - Country:US
Practice Address - Phone:803-547-5447
Practice Address - Fax:803-396-0095
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD51329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine