| Qaisar J Qayyum Md, Pc | |
|
13974 S Broadway Edmond OK 73034-8144 | |
| (405) 562-8715 | |
| (405) 562-8717 |
| Full Name | Qaisar J Qayyum Md, Pc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 13974 S Broadway, Edmond, Oklahoma |
| Authorized Official Name and Position | Qaisar J Qayyum (PRESIDENT) |
| Authorized Official Contact | 4055628715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Qaisar J Qayyum Md, Pc Po Box 31195 Edmond OK 73003 Ph: (405) 562-8715 | Qaisar J Qayyum Md, Pc 13974 S Broadway Edmond OK 73034-8144 Ph: (405) 562-8715 |
| NPI Number | 1710907613 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 06/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710907613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 21912 (Oklahoma) | Primary |
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