Individual
SHAFIQ UR RAHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
116 N 5TH ST, W HAZLETON, PA 18202-3946
(570) 454-2545
(570) 454-6191
Mailing address
PO BOX 100, MOUNTAIN TOP, PA 18707-0100
(570) 454-2545
(570) 454-6191
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD053911-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015129990009
—
PA
Enumeration date
10/27/2006
Last updated
07/08/2007
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