Provider Demographics
NPI:1194483875
Name:RAHMAN, SHAWON SYED MUJIBOR (PHD)
Entity type:Individual
Prefix:PROF
First Name:SHAWON
Middle Name:SYED MUJIBOR
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 W PUAINAKO ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-5366
Mailing Address - Country:US
Mailing Address - Phone:808-909-2099
Mailing Address - Fax:
Practice Address - Street 1:137 W PUAINAKO ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-5366
Practice Address - Country:US
Practice Address - Phone:808-909-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide