Provider Demographics
NPI:1588756886
Name:ABDUL-RAHMAN, MUSTAPHA (MD)
Entity type:Individual
Prefix:DR
First Name:MUSTAPHA
Middle Name:
Last Name:ABDUL-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 1:172 LINDEN DRIVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2892
Mailing Address - Country:US
Mailing Address - Phone:540-678-0767
Mailing Address - Fax:540-678-0769
Practice Address - Street 1:172 LINDEN DR STE 103
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2892
Practice Address - Country:US
Practice Address - Phone:540-678-0767
Practice Address - Fax:540-678-0769
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235673207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00423230OtherRR MEDICARE
VAI68794Medicare UPIN
VA00X240W01Medicare PIN