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NPI Code Detail

MEDICARE: MR. RADWAN KESSERWAN M.D.

MEDICARE: MR. RADWAN KESSERWAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician22414OK
2207RC0000XCardiovascular Disease Physician22414OK
3207RI0001XClinical & Laboratory Immunology (Internal Medicine) Physician22414OK
4207RI0011XInterventional Cardiology Physician22414OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245324433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RADWAN KESSERWAN M.D.
Provider Business Mailing Address
First Line : 608 N.W. 9TH STREET
Second Line : SUITE 6105
City : OKLAHOMA CITY
State : OK
Zip : 73102-1006
Country : US
Telephone Number : 405-231-3841
Fax Number : 405-231-3705
Provider Business Practice Location Address
First Line : 608 N.W. 9TH STREET
Second Line : SUITE 6105
City : OKLAHOMA CITY
State : OK
Zip : 73102-1006
Country : US
Telephone Number : 405-231-3841
Fax Number : 405-231-3705
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 10/21/2020

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