Organization
OKWA PEDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAZIR S AHMAD MD (OWNER)
(405) 235-9955
Entity
Organization
Contact information
Practice address
1211 N SHARTEL AVE, STE 606, OKLAHOMA CITY, OK 73103-2400
(405) 235-9955
Mailing address
1211 N SHARTEL AVE, STE 606, OKLAHOMA CITY, OK 73103-2400
(405) 235-9955
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
12461
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100118340B
—
OK
Enumeration date
07/17/2008
Last updated
07/17/2008
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