Provider Demographics
NPI:1487748406
Name:RAHMAN, MUHAMMAD MUJIBUR (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:MUJIBUR
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:814-333-3929
Mailing Address - Fax:814-373-3539
Practice Address - Street 1:765 LIBERTY ST
Practice Address - Street 2:SUITE 303
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2566
Practice Address - Country:US
Practice Address - Phone:814-333-3929
Practice Address - Fax:814-373-3539
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350946872084N0008X, 2084N0600X, 2084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001721763OtherBCBS SERVICE PROVIDER #
WVWV21335OtherHEALTH PLAN PROVIDER NBR
1487748406OtherNPI
WV3004665000Medicaid
WVP00073368OtherRAILROAD MEDICARE
OHH298420Medicaid
OHH298420Medicaid
WVP00073368OtherRAILROAD MEDICARE
WVWV21335OtherHEALTH PLAN PROVIDER NBR
1487748406OtherNPI