Organization Active NPI

Raheem Medical Clinic P C

  • Internal Medicine Physician
  • Michigan City, IN
National Provider Identifier
1851645790
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RAHEEM MEDICAL CLINIC P C
Practice address
1501 Wabash Street
Suite 105
Michigan City, IN 46360-4364
Phone
(219) 878-1300
Fax
(219) 878-9764
NPI assigned
Oct 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Authorized official

Name
Mirza Raheem, M.D.
Title
President
Phone
(219) 878-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1501 Wabash Street
Suite 105
Michigan City, IN 46360-4364

Mailing address

1501 Wabash Street
Suite 105
Michigan City, IN 46360-4364
Phone (219) 878-1300

National Provider Directory

National Provider Directory

Locations

1501 Wabash St
Ste 105
Michigan City, IN 46360
Phone (219) 878-1300

1507 Wabash St
Ste 500B
Michigan City, IN 46360
Phone (219) 805-5333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1851645790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 WABASH STREET",
            "address_2": "SUITE 105",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463604364",
            "telephone_number": "219-878-1300",
            "fax_number": "219-878-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 WABASH STREET",
            "address_2": "SUITE 105",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463604364",
            "telephone_number": "219-878-1300",
            "fax_number": "219-878-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAHEEM MEDICAL CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "RAHEEM",
        "authorized_official_first_name": "MIRZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-878-1300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.