Provider Demographics
NPI:1801318654
Name:QANI, ABDUL RAHMAN (PA-C)
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:RAHMAN
Last Name:QANI
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:15 SPRINGBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-1056
Mailing Address - Country:US
Mailing Address - Phone:207-409-3495
Mailing Address - Fax:
Practice Address - Street 1:10 STAFFORD LAKES PKWY STE 102
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22406-7305
Practice Address - Country:US
Practice Address - Phone:540-741-6982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2023-12-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical