Provider Demographics
NPI:1699775437
Name:REHMAN, SYED MASEEHUR (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:MASEEHUR
Last Name:REHMAN
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 1:7247 W CENTRAL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617
Mailing Address - Country:US
Mailing Address - Phone:419-843-8815
Mailing Address - Fax:419-843-8816
Practice Address - Street 1:7247 W CENTRAL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1177
Practice Address - Country:US
Practice Address - Phone:419-843-8815
Practice Address - Fax:419-843-8816
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070139R207K00000X
MI4301069146207K00000X
OH35071039207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0955864Medicaid
MI3403527Medicaid
F26536Medicare UPIN
MI3403527Medicaid
MIF26536Medicare UPIN
OHF26536Medicare UPIN
MIOM 49470Medicare ID - Type Unspecified