Provider Demographics
NPI:1558399808
Name:REHMAN, DURDANA TABBUSSUM (MD)
Entity Type:Individual
Prefix:
First Name:DURDANA
Middle Name:TABBUSSUM
Last Name:REHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DURDANA
Other - Middle Name:
Other - Last Name:TABBUSSUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:35450 DEQUINDRE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4810
Mailing Address - Country:US
Mailing Address - Phone:586-977-9090
Mailing Address - Fax:586-977-9393
Practice Address - Street 1:35450 DEQUINDRE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4810
Practice Address - Country:US
Practice Address - Phone:586-977-9090
Practice Address - Fax:586-977-9393
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010658542080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine