Provider Demographics
NPI:1689212854
Name:KHALID, RUMMAN AHMED (MD)
Entity Type:Individual
Prefix:MR
First Name:RUMMAN
Middle Name:AHMED
Last Name:KHALID
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 1:8201 E. RIVERSIDE BLVD.
Mailing Address - Street 2:JAVON BEA HOSPITAL-RIVERSIDE
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114
Mailing Address - Country:US
Mailing Address - Phone:815-971-7000
Mailing Address - Fax:815-971-9795
Practice Address - Street 1:2400 N. ROCKTON AVE.
Practice Address - Street 2:JAVON BEA HOSPITAL- ROCKTON
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103
Practice Address - Country:US
Practice Address - Phone:815-971-5000
Practice Address - Fax:815-971-9795
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2022-07-21
Deactivation Date:2021-05-28
Deactivation Code:
Reactivation Date:2022-04-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program