Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 13732 | WV |
NPI | 1003902370 |
---|---|
Provider Name | Dr. Asif Rahman |
First Address | Charleston, WV 25304-1062 |
Second Address | Charleston, WV 25304-1062 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 19/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0088000000 | (05) | WV |
550722686 | PRACTICE TAX ID# (01) | WV |
C04792 | (02) | WV |