Individual
DR. MOHAMMAD MOHABUBUR RAHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3350 NORTHSIDE DR, MACON, GA 31210
(478) 405-2121
(478) 405-0114
Mailing address
3350 NORTHSIDE DR, MACON, GA 31210
(478) 405-2121
(478) 405-0114
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
044065
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000764882C
—
GA
01
—
775980
BLUE CROSS BLUE SHIELD
GA
Enumeration date
09/07/2006
Last updated
07/08/2010
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