Provider Demographics
NPI:1487688412
Name:RASHWAN, AHMED SAMMY (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:SAMMY
Last Name:RASHWAN
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 1:301 E DAY RD
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3455
Mailing Address - Country:US
Mailing Address - Phone:406-327-3100
Mailing Address - Fax:406-327-2141
Practice Address - Street 1:900 N ORANGE ST STE 106
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-2951
Practice Address - Country:US
Practice Address - Phone:406-327-3100
Practice Address - Fax:406-327-2141
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53530207RC0200X, 207RS0012X
IN01085372A207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO118045OtherSTATE MEDICAL LICENSE
IL036101038OtherSTATE MEDICAL LICENSE
OH35083809OtherSTATE MEDICAL LICENSE
NC9901298OtherSTATE MEDICAL LICENSE
CAC53530OtherSTATE MEDICAL LICENSE
CA549584OtherAMERICAN BOARD OF INTERNAL MEDICINE