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General NPI Number Information
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NPI Number | 1609515139
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Entity Type | Organization
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Legal Business Name | RAMADAN MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 2836 N KELLY AVE
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City | EDMOND
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State | OK
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Zip | 73003-3153
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Country | US
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Telephone | 312-515-1356
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Fax |
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Provider Business Mailing Address
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Address Line | 2836 N KELLY AVE
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City | EDMOND
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State | OK
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Zip | 73003-3153
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Country | US
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Telephone | 312-515-1356
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/MD
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Name | SUHA TAWFIK RAMADAN
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Credential | MD
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Telephone | 312-515-1356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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