Provider Demographics
NPI:1538144894
Name:RAHMAN, MUHAMMED HAFIZ (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMED
Middle Name:HAFIZ
Last Name:RAHMAN
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 1:250 VILLAGE CENTER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9044
Mailing Address - Country:US
Mailing Address - Phone:678-289-0508
Mailing Address - Fax:770-692-0301
Practice Address - Street 1:250 VILLAGE CENTER PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9044
Practice Address - Country:US
Practice Address - Phone:678-289-0508
Practice Address - Fax:770-692-0301
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048381207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000870251AMedicaid
GAG41260Medicare UPIN
GA390007758Medicare ID - Type UnspecifiedRAILROAD MEDICARE
GA39BDCBRMedicare ID - Type Unspecified