Provider Demographics
NPI:1962411660
Name:RAHMAN, AHMED A (MD)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:A
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:PO BOX 11314
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4004
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:113 GAINSBOROUGH SQ STE 400
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1714
Practice Address - Country:US
Practice Address - Phone:757-842-4499
Practice Address - Fax:757-842-4490
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010101348522086S0129X
VA0101034852208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA020001348OtherMEDICARE ID
VA326443OtherANTHEM
VA247408OtherCIGNA
513294OtherMAMSI - VASCULAR
VA020041654OtherPALMETTO MEDICARE ID
VA35020OtherOPTIMA
413294OtherMAMSI - GENERAL
NC690570UMedicaid
VA7309562Medicaid
513294OtherMAMSI - VASCULAR
VACI6552Medicare PIN
B06025Medicare UPIN