Provider Demographics
NPI:1770373771
Name:AHMAD, RAWAN (PA)
Entity type:Individual
Prefix:
First Name:RAWAN
Middle Name:
Last Name:AHMAD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9359 HELMSLEY DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-2374
Mailing Address - Country:US
Mailing Address - Phone:901-831-5555
Mailing Address - Fax:
Practice Address - Street 1:940 BYHALIA RD
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-1017
Practice Address - Country:US
Practice Address - Phone:901-831-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant