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Organization

NUSRAT RAHMAN MD PC

Active
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Organization

NUSRAT RAHMAN MD PC

Active
Other names
S.M. Rahman MD PC
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. NUSRAT Z RAHMAN M.D. (OWNER)
(313) 590-7705
Entity
Organization

Contact information

Practice address
3781 FORT ST, LINCOLN PARK, MI 48146-4118
(313) 381-7430
(313) 381-7958
Mailing address
3781 FORT ST, LINCOLN PARK, MI 48146-4118
(313) 381-7430
(313) 381-7958

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
NR043492
MI
208600000X
Surgery Physician
SR033102
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0208208989
BCBS
MI
05
1092811 TYPE10
MI
01
110 8222342
BCBS
MI
05
2124310 TYPE10
MI
Enumeration date
04/08/2008
Last updated
04/08/2015
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