Provider Demographics
NPI:1811226483
Name:RAHAT, SYED MUNIR (RPT)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:MUNIR
Last Name:RAHAT
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 S LOVINGTON DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4352
Mailing Address - Country:US
Mailing Address - Phone:734-624-6862
Mailing Address - Fax:
Practice Address - Street 1:2119 S LOVINGTON DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-4352
Practice Address - Country:US
Practice Address - Phone:734-624-6862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist