Provider Demographics
NPI:1285087536
Name:JAVED, ISMA NUSRAT (MD)
Entity type:Individual
Prefix:DR
First Name:ISMA
Middle Name:NUSRAT
Last Name:JAVED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SSM HEALTH MEDICAL GROUP
Mailing Address - Street 2:3315 KETHEY
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804
Mailing Address - Country:US
Mailing Address - Phone:404-273-5801
Mailing Address - Fax:
Practice Address - Street 1:SSM HEALTH MEDICAL GROUP
Practice Address - Street 2:3315 KETHEY
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804
Practice Address - Country:US
Practice Address - Phone:404-273-5801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32274207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine