Provider Demographics
NPI:1396910873
Name:RABBANI, RAIHAN (MD)
Entity type:Individual
Prefix:
First Name:RAIHAN
Middle Name:
Last Name:RABBANI
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 1:35454 RAVINE BLVD
Mailing Address - Street 2:APT 305
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2467
Mailing Address - Country:US
Mailing Address - Phone:586-536-0383
Mailing Address - Fax:
Practice Address - Street 1:6071 W OUTER DR
Practice Address - Street 2:INTERNAL MEDICINE DEPARTMENT, SINAI GRACE HOSPITAL,
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2624
Practice Address - Country:US
Practice Address - Phone:313-966-6777
Practice Address - Fax:313-966-1738
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1152349207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine