Provider Demographics
NPI:1568413284
Name:AMIL, AZHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:AZHAR
Middle Name:
Last Name:AMIL
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 1:3433 NW 56TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4430
Mailing Address - Country:US
Mailing Address - Phone:405-947-3341
Mailing Address - Fax:405-917-3590
Practice Address - Street 1:3433 NW 56TH ST STE 660
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4449
Practice Address - Country:US
Practice Address - Phone:405-948-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12579207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100226600BMedicaid
OKD38605Medicare UPIN