Individual
FATEH ELKHATIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4221 S WESTERN AVE STE 3030, OKLAHOMA CITY, OK 73109-3492
(405) 644-6232
(405) 636-7468
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(405) 644-6232
(405) 636-7468
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28367
OK
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
28367
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8469413
—
WA
01
—
G000362000
MEDICARE GROUP
WA
01
—
P00395883
RR MEDICARE ID
WA
Enumeration date
08/22/2006
Last updated
02/03/2016
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