Provider Demographics
NPI:1366883670
Name:RAHMATULLAH, SYED IQBQL (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:IQBQL
Last Name:RAHMATULLAH
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:244 KENNEDY MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4538
Mailing Address - Country:US
Mailing Address - Phone:207-861-8030
Mailing Address - Fax:207-860-8317
Practice Address - Street 1:244 KENNEDY MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4538
Practice Address - Country:US
Practice Address - Phone:207-861-8030
Practice Address - Fax:207-860-8317
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEMD19744207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease