Provider Demographics
NPI:1376544379
Name:RAHIMI-SABER, SHAHRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHRAM
Middle Name:
Last Name:RAHIMI-SABER
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 1:794 POLO RUN DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-1399
Mailing Address - Country:US
Mailing Address - Phone:901-850-7788
Mailing Address - Fax:
Practice Address - Street 1:794 POLO RUN DR
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-1399
Practice Address - Country:US
Practice Address - Phone:901-850-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35635207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3866086Medicaid
TN3866089Medicaid
TN3866086Medicaid
TN3866089Medicare PIN
TNH41885Medicare UPIN
TN3866086Medicare ID - Type Unspecified