Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 34989 | OK |
NPI | 1194071712 |
---|---|
Provider Name | Qassim Ali Abid |
First Address | Oklahoma City, OK 73104-4637 |
Second Address | Oklahoma City, OK 73104-4637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2012 |
Last Update Date | 30/04/2020 |