| Medi Practice Management LLC | |
|
3008 Nw 168th Ct Edmond OK 73012-6787 | |
| (580) 210-0040 | |
| Not Available |
| Full Name | Medi Practice Management LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3008 Nw 168th Ct, Edmond, Oklahoma |
| Authorized Official Name and Position | Samina Anwar (OWNER) |
| Authorized Official Contact | 5802100040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medi Practice Management LLC 3008 Nw 168th Ct Edmond OK 73012-6787 Ph: (580) 210-0040 | Medi Practice Management LLC 3008 Nw 168th Ct Edmond OK 73012-6787 Ph: (580) 210-0040 |
| NPI Number | 1962024893 |
|---|---|
| Provider Enumeration Date | 05/14/2020 |
| Last Update Date | 05/14/2020 |
| Certification Date | 05/14/2020 |
| Medicare PECOS PAC ID | 7012338809 |
|---|---|
| Medicare Enrollment ID | O20200603001137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962024893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Sarfaraz Anwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467408021 PECOS PAC ID: 6901793157 Enrollment ID: I20040302000752 |
| Provider Name | Syed Hamza Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396123535 PECOS PAC ID: 4385916964 Enrollment ID: I20170816002736 |
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