Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 38294 | OK |
NPI | 1053934133 |
---|---|
Provider Name | Abdul Qadar |
First Address | Oklahoma City, OK 73104-5036 |
Second Address | Oklahoma City, OK 73104-5036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2020 |
Last Update Date | 12/01/2022 |