| Crescent Infectious Diseases Pllc | |
|
1111 N Lee Ave Ste 249 Oklahoma City OK 73103-2600 | |
| (855) 541-2862 | |
| (405) 716-4808 |
| Full Name | Crescent Infectious Diseases Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 N Lee Ave Ste 249, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Waqas Hussain (OFFICE MANAGER) |
| Authorized Official Contact | 8555412862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Infectious Diseases Pllc 1111 N Lee Ave Ste 249 Oklahoma City OK 73103-2600 Ph: (855) 541-2862 | Crescent Infectious Diseases Pllc 1111 N Lee Ave Ste 249 Oklahoma City OK 73103-2600 Ph: (855) 541-2862 |
| NPI Number | 1538501028 |
|---|---|
| Provider Enumeration Date | 07/24/2013 |
| Last Update Date | 04/07/2020 |
| Medicare PECOS PAC ID | 8820222847 |
|---|---|
| Medicare Enrollment ID | O20131007000930 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538501028 | NPI | - | NPPES |
| 29704 | Other | OK | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 29704 (Oklahoma) | Primary |
| Provider Name | Matthew Mcgill |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1447543764 PECOS PAC ID: 5294909263 Enrollment ID: I20111201000348 |
| Provider Name | Girish J Murthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013146398 PECOS PAC ID: 3476701731 Enrollment ID: I20120912000471 |
| Provider Name | Saud Iqbal Ahmed |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1558507962 PECOS PAC ID: 5991851131 Enrollment ID: I20131120000644 |
| Provider Name | Ahmad Ashfaq |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1871729517 PECOS PAC ID: 5193995736 Enrollment ID: I20140509001041 |
| Provider Name | Vijay Kolli |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1013017292 PECOS PAC ID: 5092818922 Enrollment ID: I20150915000627 |
| Provider Name | Yasir Ahmed |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1023292976 PECOS PAC ID: 8628226537 Enrollment ID: I20180621000349 |
| Provider Name | Dylan Shockley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588295836 PECOS PAC ID: 9335561604 Enrollment ID: I20200616000948 |
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