Provider Demographics
NPI:1598747099
Name:RAHMAN, RAFIQ U (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFIQ
Middle Name:U
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1107 WOODLAND DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2789
Mailing Address - Country:US
Mailing Address - Phone:270-769-6665
Mailing Address - Fax:270-769-0322
Practice Address - Street 1:1107 WOODLAND DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2789
Practice Address - Country:US
Practice Address - Phone:270-769-6665
Practice Address - Fax:270-769-0322
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY27724207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64277247Medicaid
KY1048930OtherPASSPORT
KYE92500Medicare UPIN
KY1363803Medicare PIN