Provider Demographics
NPI:1841273216
Name:RAHIMIAN, ALI A (MD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:A
Last Name:RAHIMIAN
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:PO BOX 2308
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26302-2308
Mailing Address - Country:US
Mailing Address - Phone:304-622-1264
Mailing Address - Fax:304-622-0204
Practice Address - Street 1:300 DAVISSON RUN RD
Practice Address - Street 2:SUITE 203
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-9304
Practice Address - Country:US
Practice Address - Phone:304-622-1264
Practice Address - Fax:304-622-0204
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV11608207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV245004OtherCARELINK/COVENTRY
WVWV11608DOtherHEALTH PLAN #
WV5116317OtherALLIANCE PROVIDER #
WV0094094000Medicaid
WV5116317OtherMAMSI PROVIDER #
WV7298181Medicare PIN
WVC34971Medicare UPIN
WV5116317OtherMAMSI PROVIDER #