Provider Demographics
NPI:1144370578
Name:RAHMAN, HYTHEM (DC)
Entity type:Individual
Prefix:DR
First Name:HYTHEM
Middle Name:
Last Name:RAHMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20299 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1181
Mailing Address - Country:US
Mailing Address - Phone:313-949-6206
Mailing Address - Fax:
Practice Address - Street 1:20299 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1181
Practice Address - Country:US
Practice Address - Phone:313-949-6206
Practice Address - Fax:419-715-9554
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRA4130911Medicare ID - Type UnspecifiedMEDICARE
OHU99679Medicare UPIN