Provider Demographics
NPI:1700807187
Name:RAHMAN, HABIBUR (MD)
Entity Type:Individual
Prefix:
First Name:HABIBUR
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 1:1435 WOODALL TRCE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-0676
Mailing Address - Country:US
Mailing Address - Phone:770-557-6061
Mailing Address - Fax:
Practice Address - Street 1:1435 WOODALL TRCE
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-0676
Practice Address - Country:US
Practice Address - Phone:770-557-6061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023209208000000X
IL036059296208000000X
MOR5D06208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics