Provider Demographics
NPI:1336180199
Name:RAHIMIAN, HYDEH (MD)
Entity Type:Individual
Prefix:DR
First Name:HYDEH
Middle Name:
Last Name:RAHIMIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-2438
Mailing Address - Country:US
Mailing Address - Phone:812-465-5669
Mailing Address - Fax:812-485-6767
Practice Address - Street 1:500 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-2438
Practice Address - Country:US
Practice Address - Phone:812-465-5669
Practice Address - Fax:812-485-6767
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01050203207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000106958OtherANTHEM PROVIDER#
IN100180890FMedicaid
IN200122140Medicaid
IN080154921OtherINDIVRAILROAD MEDICARE #
INE99155OtherUPIN#
IN100180890FMedicaid