Provider Demographics
NPI:1427095066
Name:RAHMAN, SYED HABEEBUR (MD)
Entity type:Individual
Prefix:MR
First Name:SYED
Middle Name:HABEEBUR
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2876 GUARDIAN LANE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7327
Mailing Address - Country:US
Mailing Address - Phone:757-463-5240
Mailing Address - Fax:757-463-6572
Practice Address - Street 1:3235 ACADEMY AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3200
Practice Address - Country:US
Practice Address - Phone:757-686-9300
Practice Address - Fax:757-686-1514
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010376862084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7110146Medicaid
NC890515FMedicaid
NC0557HOtherBLUE CROSS BLUE SHIELD
VA410889OtherMPIPA OPTIMA CHOICE
VA0500072OtherUNITED HEALTHCARE
VA394012OtherANTHEM
VA40287OtherVIRGINIA CHARTERED HEALTH
VA50076481OtherHEALTHNET TRICARE CHAMPUS
VA27344OtherSENTARA
VA410889OtherMPIPA OPTIMA CHOICE