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Organization
INFECTIOUS DISEASE ASSOCIATES LLC
Active
Organization
INFECTIOUS DISEASE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BUSHRA SIDDIQUE MD (PRESIDENT)
(405) 694-4966
Entity
Organization
Contact information
Practice address
5401 N PORTLAND AVE, SUITE 220, OKLAHOMA CITY, OK 73112-2121
(405) 604-4321
(405) 604-4331
Mailing address
820 W DANFORTH RD, SUITE 302, EDMOND, OK 73003-5006
(405) 694-4966
(405) 604-4331
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
29723
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200522840A
—
OK
Enumeration date
10/21/2016
Last updated
10/21/2016
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