Provider Demographics
NPI:1912196114
Name:RAHMAN, AISHA (MD)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1493 S HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1493 S HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3416
Practice Address - Country:US
Practice Address - Phone:330-865-5333
Practice Address - Fax:330-865-5331
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.097087207Q00000X
GA060088207Q00000X
VA390200000X
OH097087208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG60088Medicaid
GA740224320AMedicaid
OH0055505Medicaid
SCG60088Medicaid
OHH006391Medicare PIN