Provider Demographics
NPI:1487661070
Name:ABDUL-RAHMAN, SHARAN (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:SHARAN
Middle Name:
Last Name:ABDUL-RAHMAN
Suffix:
Gender:F
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7943
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19101-7943
Mailing Address - Country:US
Mailing Address - Phone:267-979-8400
Mailing Address - Fax:
Practice Address - Street 1:322 E MONTANA ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2009
Practice Address - Country:US
Practice Address - Phone:267-979-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034937E207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E99941Medicare UPIN