Provider Demographics
NPI:1376633321
Name:RAHMAN, UMAR FAROOQ (MD)
Entity Type:Individual
Prefix:
First Name:UMAR
Middle Name:FAROOQ
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 1:11215 OAK LEAF DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1317
Mailing Address - Country:US
Mailing Address - Phone:301-593-1315
Mailing Address - Fax:301-681-4699
Practice Address - Street 1:11215 OAK LEAF DR
Practice Address - Street 2:SUITE 108
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1317
Practice Address - Country:US
Practice Address - Phone:301-593-1315
Practice Address - Fax:301-681-4699
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00563922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405827500Medicaid
MD589411500Medicaid
MD405827500Medicaid
MD653140Medicare UPIN
MD589411500Medicaid
DC015727P32Medicare ID - Type Unspecified