Healthcare Provider Details

I. General information

NPI: 1407466600
Provider Name (Legal Business Name): ABDUL KADER SAIFUDDIN SURTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6151 S YALE AVE # LEVELB
TULSA OK
74136-1907
US

IV. Provider business mailing address

CLEVELAND CLINIC 9500 EUCLID AVENUE/ JJ24
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-6097
  • Fax: 918-502-6046
Mailing address:
  • Phone: 216-444-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number47229
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: