Provider Demographics
NPI:1619048733
Name:RAHMAN, INAM UR (MD)
Entity Type:Individual
Prefix:DR
First Name:INAM
Middle Name:UR
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:50 S BERETANIA ST
Mailing Address - Street 2:SUITE C210 A1
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2208
Mailing Address - Country:US
Mailing Address - Phone:808-521-1165
Mailing Address - Fax:180-852-1185
Practice Address - Street 1:50 S BERETANIA ST
Practice Address - Street 2:SUITE C210 A1
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2208
Practice Address - Country:US
Practice Address - Phone:808-521-1165
Practice Address - Fax:180-852-1185
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7993207RS0010X
HIMD7993207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI54351301Medicaid
HIH000BFBGFMedicare PIN