Provider Demographics
NPI:1891146189
Name:ABDUL-RAHMAN, YASIR (DO)
Entity Type:Individual
Prefix:
First Name:YASIR
Middle Name:
Last Name:ABDUL-RAHMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13575 HEATHCOTE BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-6698
Mailing Address - Country:US
Mailing Address - Phone:571-248-4620
Mailing Address - Fax:571-248-4374
Practice Address - Street 1:13575 HEATHCOTE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-6698
Practice Address - Country:US
Practice Address - Phone:571-248-4620
Practice Address - Fax:571-248-4374
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102206134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine