Provider Demographics
NPI:1063109056
Name:RAHMAN, MASUM (MBBS)
Entity type:Individual
Prefix:
First Name:MASUM
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 1ST ST SW APT 14
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-6271
Mailing Address - Country:US
Mailing Address - Phone:507-319-9044
Mailing Address - Fax:
Practice Address - Street 1:855 1ST ST SW APT 14
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-6271
Practice Address - Country:US
Practice Address - Phone:507-319-9044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program