Provider Demographics
NPI:1457693327
Name:RAHMAN, RIZWANA YASMIN (DO)
Entity Type:Individual
Prefix:DR
First Name:RIZWANA
Middle Name:YASMIN
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RIZWANA
Other - Middle Name:
Other - Last Name:YASMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30795 TWENTY-THREE MILE ROAD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CHESTERFIELD TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48047
Mailing Address - Country:US
Mailing Address - Phone:586-421-3150
Mailing Address - Fax:586-421-3151
Practice Address - Street 1:30795 TWENTY-THREE MILE ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:CHESTERFIELD TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48047
Practice Address - Country:US
Practice Address - Phone:586-421-3150
Practice Address - Fax:586-421-3151
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020398207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine