Provider Demographics
NPI:1295782670
Name:RAHMAN, SALIM (MD)
Entity type:Individual
Prefix:
First Name:SALIM
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9434
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-9434
Mailing Address - Country:US
Mailing Address - Phone:417-885-3888
Mailing Address - Fax:417-881-7638
Practice Address - Street 1:3801 S NATIONAL AVE
Practice Address - Street 2:WEST TOWER, SUITE 700
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5210
Practice Address - Country:US
Practice Address - Phone:417-885-3888
Practice Address - Fax:417-881-7638
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112080207T00000X
ARC8141207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR133549001Medicaid
MO2359OtherCOX HEALTH PLANS UPI
WA0200866OtherDEPARTMENT OF LABOR WA
MO02100024800OtherQUAL CHOICE
MO18942OtherCOX HEALTH PLANS
MO208708206Medicaid
MO330907OtherHEALTHLINK
MO4188130001OtherCIGNA MEDICARE
AR5M328OtherARKANSAS FIRST SOURCE
AR5M328OtherHEALTH ADVANTAGE
MO0602000OtherUNITED HEALTHCARE
MO107710OtherBLUE CROSS/CHOICE
MOG49864OtherUSPS (W/C)
AR5M328OtherARKANSAS BC/BS
MO6749504001OtherCIGNA HEALTHCARE
MOMA3059003Medicare PIN
MO140007246Medicare PIN
MO18942OtherCOX HEALTH PLANS
AR5M328Medicare PIN
WA0200866OtherDEPARTMENT OF LABOR WA
MO107710OtherBLUE CROSS/CHOICE
MO4188130001OtherCIGNA MEDICARE
AR5M328OtherARKANSAS BC/BS