Provider Demographics
NPI:1679507024
Name:RAHMAN, NAIM U (MD)
Entity Type:Individual
Prefix:DR
First Name:NAIM
Middle Name:U
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:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:MS
Mailing Address - Zip Code:39341-0480
Mailing Address - Country:US
Mailing Address - Phone:662-726-4620
Mailing Address - Fax:662-726-4204
Practice Address - Street 1:606 NORTH JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:MS
Practice Address - Zip Code:39341
Practice Address - Country:US
Practice Address - Phone:662-726-4620
Practice Address - Fax:662-726-4204
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17010207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0123412Medicaid
MS0123412Medicaid