Provider Demographics
NPI:1225062359
Name:AHMAD, VAQAR (MD)
Entity Type:Individual
Prefix:
First Name:VAQAR
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:VAQAR
Other - Middle Name:
Other - Last Name:AHMAD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-0340
Mailing Address - Country:US
Mailing Address - Phone:405-736-6095
Mailing Address - Fax:405-736-6682
Practice Address - Street 1:8121 NATIONAL AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7530
Practice Address - Country:US
Practice Address - Phone:405-736-6095
Practice Address - Fax:405-736-6682
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22730207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200039810AMedicaid
0-470-892-02OtherECFMG NUMBER
OK249631004Medicare PIN
OKI22654Medicare UPIN