Provider Demographics
NPI:1407083660
Name:WAHAB, RIFAT A (DO)
Entity Type:Individual
Prefix:DR
First Name:RIFAT
Middle Name:A
Last Name:WAHAB
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:RIFAT
Other - Middle Name:A
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2830 VICTORY PARKWAY
Mailing Address - Street 2:CENTRAL CREDENTIALING - 2ND FLOOR
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206
Mailing Address - Country:US
Mailing Address - Phone:513-585-5502
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:234 GOODMAN ST.
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-584-5335
Practice Address - Fax:513-584-3633
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0820122085R0202X
OH340118572085R0202X
TN26492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology