Provider Demographics
NPI:1992816136
Name:RAHMANI, SHERVIN (MD)
Entity type:Individual
Prefix:
First Name:SHERVIN
Middle Name:
Last Name:RAHMANI
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 1:6005 PARK AVE
Mailing Address - Street 2:SUITE 728B
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119
Mailing Address - Country:US
Mailing Address - Phone:901-761-9097
Mailing Address - Fax:901-682-7635
Practice Address - Street 1:6005 PARK AVE
Practice Address - Street 2:SUITE 728B
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119
Practice Address - Country:US
Practice Address - Phone:901-761-9097
Practice Address - Fax:901-682-7635
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67716207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1945397OtherUNITED HEALTHCARE
TN4109425OtherBLUE CROSS
TNP00253055OtherRAILROAD MEDICARE
TN1560377OtherCIGNA
TN7150070OtherAETNA
TN4109425OtherBLUE CROSS
TN7150070OtherAETNA