Provider Demographics
NPI:1629402342
Name:RAHMAN, SAMINA ASMA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMINA
Middle Name:ASMA
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6644 E BAYWOOD AVE
Mailing Address - Street 2:BANNER BAYWOOD MEDICAL CENTER
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206
Mailing Address - Country:US
Mailing Address - Phone:480-321-3900
Mailing Address - Fax:480-321-3840
Practice Address - Street 1:6644 E BAYWOOD AVE
Practice Address - Street 2:BANNER BAYWOOD MEDICAL CENTER
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-321-3900
Practice Address - Fax:480-321-3840
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ51082208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine