Provider Demographics
NPI:1679637409
Name:RAHMAN, ATIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ATIRA
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W CHEW ST
Mailing Address - Street 2:PHYSICIAN ACCOUNTS
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-3406
Mailing Address - Country:US
Mailing Address - Phone:610-776-5100
Mailing Address - Fax:610-663-3113
Practice Address - Street 1:450 W CHEW ST
Practice Address - Street 2:SIGAL CENTER 2ND FLOOR
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3434
Practice Address - Country:US
Practice Address - Phone:610-776-5160
Practice Address - Fax:610-606-4457
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425097208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1925006OtherHIGHMARK BLUE SHIELD
PACAPITAL BLUE CROSSOther50065416
PA2793782000OtherIBC
PAP008305OtherGATEWAY HEALTH PLAN
PA1018415970001Medicaid
PA000000200056OtherUNISON HEALTH PLAN
PAAMERIHEALTH MERCYOther20058816
PA1018415970001Medicaid