Provider Demographics
NPI:1871687038
Name:RAHMAN, KHAWAJA M (MD,)
Entity Type:Individual
Prefix:
First Name:KHAWAJA
Middle Name:M
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 1:171 KINSLEY ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3654
Mailing Address - Country:US
Mailing Address - Phone:603-881-7100
Mailing Address - Fax:603-598-9049
Practice Address - Street 1:171 KINSLEY ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3654
Practice Address - Country:US
Practice Address - Phone:603-881-7100
Practice Address - Fax:603-598-9049
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH76552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH10905443OtherCAQH
NH30002941Medicaid
NH5301415OtherFIRST HEALTH
NH376681OtherMVP HEALTHCARE
NH10905443OtherCAQH
NH5301415OtherFIRST HEALTH