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General NPI Number Information
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NPI Number | 1396100152
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Entity Type | Organization
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Legal Business Name | CRESCENT INFECTIOUS DISEASES PLLC
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 5224 E I 240 SERVICE RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73135-2607
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Country | US
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Telephone | 855-541-2862
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Fax |
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Provider Business Mailing Address
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Address Line | 5224 E I 240 SERVICE RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73135-2607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SAUD AHMED
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Credential | M.D
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Telephone | 405-563-3998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 29704
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License Number State | OK
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