Provider Demographics
NPI:1770623068
Name:LATIF, FAISAL (MD)
Entity type:Individual
Prefix:
First Name:FAISAL
Middle Name:
Last Name:LATIF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1104 E STATE HIGHWAY 152
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-5116
Mailing Address - Country:US
Mailing Address - Phone:405-563-3998
Mailing Address - Fax:405-716-4808
Practice Address - Street 1:825 NE 10TH ST STE 2500
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5417
Practice Address - Country:US
Practice Address - Phone:405-271-7001
Practice Address - Fax:405-271-7034
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
OK22919207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease