Provider Demographics
NPI:1689672263
Name:WASI, FAISAL (MD)
Entity Type:Individual
Prefix:DR
First Name:FAISAL
Middle Name:
Last Name:WASI
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 1:905 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-1611
Mailing Address - Country:US
Mailing Address - Phone:918-967-0072
Mailing Address - Fax:
Practice Address - Street 1:905 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-1611
Practice Address - Country:US
Practice Address - Phone:918-967-0072
Practice Address - Fax:918-967-5040
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1123832207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease