Individual
TARIQ BUSHNAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 CHILDREN'S AVE SUITE 14405, OKLAHOMA CITY, OK 73104
(405) 271-4417
Mailing address
1200 CHILDREN'S AVE SUITE 14405, OKLAHOMA CITY, OK 73104
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
43468
OK
Other
Enumeration date
06/12/2024
Last updated
09/29/2024
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