Provider Demographics
NPI:1598710444
Name:MARWAHA, RAHUL (PT)
Entity type:Individual
Prefix:MR
First Name:RAHUL
Middle Name:
Last Name:MARWAHA
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 HOLLY POINTE CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6699
Mailing Address - Country:US
Mailing Address - Phone:302-220-0884
Mailing Address - Fax:
Practice Address - Street 1:655 MOLLY LN STE 100
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-6519
Practice Address - Country:US
Practice Address - Phone:770-517-1080
Practice Address - Fax:302-998-7498
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010597225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000100919OtherDPCI
DE3748322000OtherIBC
DEP00359634OtherMEDICARE RAILROAD
DE1598710444Medicaid
Q65232Medicare UPIN
DE1598710444Medicaid
DEG02348D04Medicare PIN