Provider Demographics
NPI:1811374770
Name:AHMED, SARFRAZ
Entity Type:Individual
Prefix:DR
First Name:SARFRAZ
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:SARFRAZ
Other - Middle Name:
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:412 SANTA FE TER
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-4452
Mailing Address - Country:US
Mailing Address - Phone:405-625-1191
Mailing Address - Fax:
Practice Address - Street 1:412 SANTA FE TER
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-4452
Practice Address - Country:US
Practice Address - Phone:405-625-1191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31362207P00000X, 207QA0401X, 207QA0505X, 207QH0002X, 208800000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice