Provider Demographics
NPI:1063975332
Name:RAHMANI, HODA (MD)
Entity type:Individual
Prefix:
First Name:HODA
Middle Name:
Last Name:RAHMANI
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 1:25651 COUNTY ROAD 20
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-2310
Mailing Address - Country:US
Mailing Address - Phone:571-244-2261
Mailing Address - Fax:
Practice Address - Street 1:25651 COUNTY ROAD 20
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-2310
Practice Address - Country:US
Practice Address - Phone:571-244-2261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319168207Q00000X
390200000X
IN01097344A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program