Provider Demographics
NPI:1366504128
Name:KUNDI, IRFAN KARIM (MD)
Entity Type:Individual
Prefix:DR
First Name:IRFAN
Middle Name:KARIM
Last Name:KUNDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S WHEELING AVE
Mailing Address - Street 2:STE 510
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5649
Mailing Address - Country:US
Mailing Address - Phone:918-747-5200
Mailing Address - Fax:
Practice Address - Street 1:2000 S WHEELING AVE
Practice Address - Street 2:STE 510
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5649
Practice Address - Country:US
Practice Address - Phone:918-747-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4666207R00000X
MN103700207R00000X
MN51162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35329900Medicaid
IAENROLLEDMedicaid
MNENROLLEDMedicaid
IAENROLLEDMedicaid