Provider Demographics
NPI:1013144211
Name:RAHMAN, MD.MUSHFIQUR (MD)
Entity Type:Individual
Prefix:DR
First Name:MD.MUSHFIQUR
Middle Name:
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 1:562 WYOMING AVE
Mailing Address - Street 2:FIRST HOSPITAL
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3721
Mailing Address - Country:US
Mailing Address - Phone:570-552-3865
Mailing Address - Fax:570-552-3643
Practice Address - Street 1:562 WYOMING AVE
Practice Address - Street 2:FIRST HOSPITAL
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3721
Practice Address - Country:US
Practice Address - Phone:570-552-3865
Practice Address - Fax:570-552-3643
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4477142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry