Provider Demographics
NPI:1962822072
Name:MUJAHID, REHAN (DO)
Entity Type:Individual
Prefix:
First Name:REHAN
Middle Name:
Last Name:MUJAHID
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 1:3445 HIGH POINT BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7817
Mailing Address - Country:US
Mailing Address - Phone:610-866-5555
Mailing Address - Fax:610-866-3151
Practice Address - Street 1:759 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1619
Practice Address - Country:US
Practice Address - Phone:413-794-6297
Practice Address - Fax:413-794-1767
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA270447207R00000X, 208M00000X
PAOS022117207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist