NPIMap

Organization Active NPI

Mujib Rahman MD Medical Clinic LLC

  • Neurology Physician
  • Warren, OH
National Provider Identifier
1578949517
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35094687 Issued in OH
Legal business name
MUJIB RAHMAN MD MEDICAL CLINIC LLC
Practice address
2512 E Market St Unit B
Warren, OH 44483-6266
Phone
(330) 766-0138
NPI assigned
Jul 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Muhammad Mujibur Rahman, MD
Title
MD/Owner
Phone
(330) 766-0138

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X 35094687 OH Primary
Clinical Neurophysiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0600X 35094687 OH

Addresses

Primary practice location

2512 E Market St Unit B
Warren, OH 44483-6266

Mailing address

1606 Avalon Creek Blvd
Vienna, OH 44473-9558

Other identifiers 4

IdentifierTypeStateIssuer
001721763OtherWVBCBS SERVICE PROVIDER
3004665000MedicaidWV
1487748406OtherNPI
H298420MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Mujib Rahman MD Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2512 E Market St
Unit B
Warren, OH 44483
Phone (330) 766-0138

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1578949517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 AVALON CREEK BLVD",
            "city": "VIENNA",
            "state": "OH",
            "postal_code": "444739558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 E MARKET ST UNIT B",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836266",
            "telephone_number": "330-766-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUJIB RAHMAN MD MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "MUJIBUR",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "330-766-0138",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35094687",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OH",
            "license": "35094687",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SERVICE PROVIDER",
            "identifier": "001721763",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004665000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1487748406",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H298420",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.