Individual ProviderRahim FazalInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1500 Oglethorpe Ave Ste 200d, Athens, GA 30606-2165(706) 389-3860PECOS EnrollmentBased on the most recent information from CMS, provider Rahim Fazal is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1972189710Provider TypeIndividualFull NameFazal, RahimTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date3/22/2021Last Updated4/1/2024Contact InformationPractice LocationPractice Address1500 Oglethorpe Ave Ste 200d, Athens, GA 30606-2165Phone(706) 389-3860FaxUnlisted FaxMailing LocationMailing Address1230 Baxter St, Athens, GA 30606-3712Phone(706) 389-3860FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense98724GeorgiaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer