Provider Demographics
NPI:1477668184
Name:MAHABIR, RAMAN CHAOS (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMAN
Middle Name:CHAOS
Last Name:MAHABIR
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 1:5780 N SWAN RD STE 180
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-4527
Mailing Address - Country:US
Mailing Address - Phone:520-448-9490
Mailing Address - Fax:520-448-9492
Practice Address - Street 1:5780 N SWAN RD STE 180
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-4527
Practice Address - Country:US
Practice Address - Phone:520-448-9490
Practice Address - Fax:520-448-9492
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ48598208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV11983OtherMEDICAL LICENSE
NVBM9933804OtherDEA CERTIFICATE