Provider Demographics
NPI:1407430556
Name:ALKEBULAN, RAHOTEP ANNU (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:RAHOTEP
Middle Name:ANNU
Last Name:ALKEBULAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:707 N ALVERNON WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1830
Mailing Address - Country:US
Mailing Address - Phone:520-694-8888
Mailing Address - Fax:520-694-1640
Practice Address - Street 1:707 N ALVERNON WAY STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1830
Practice Address - Country:US
Practice Address - Phone:520-694-8888
Practice Address - Fax:520-694-1640
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR78552207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5206948888Medicaid