Healthcare Provider Details

I. General information

NPI: 1720230410
Provider Name (Legal Business Name): ABDUL N FTESI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4418
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE 280
OKLAHOMA CITY OK
73112-5556
US

V. Phone/Fax

Practice location:
  • Phone: 405-713-7403
  • Fax: 405-713-2794
Mailing address:
  • Phone: 405-713-7403
  • Fax: 405-713-2794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number28447
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: