Organization
OKWAPEDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAZIR S AHMAD M.D. (OWNER)
(405) 235-9955
Entity
Organization
Contact information
Practice address
1211 N SHARTEL AVE STE 606, OKLAHOMA CITY, OK 73103-2425
(405) 235-9955
(405) 601-4044
Mailing address
1211 N SHARTEL AVE STE 606, OKLAHOMA CITY, OK 73103-2425
(405) 235-9955
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
12416
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100118340B
—
OK
Enumeration date
01/12/2010
Last updated
01/12/2010
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