Healthcare Provider Details

I. General information

NPI: 1710116975
Provider Name (Legal Business Name): ADNAN SAFDAR MD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE STE 5D
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

1200 CHILDRENS AVE STE 5D
OKLAHOMA CITY OK
73104-4637
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4211
  • Fax: 405-271-1154
Mailing address:
  • Phone: 405-271-4211
  • Fax: 405-271-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number46980
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number003568
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number45148
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: