Provider Demographics
NPI:1306137328
Name:NAQVI, NAZISH R (IDMT)
Entity type:Individual
Prefix:
First Name:NAZISH
Middle Name:R
Last Name:NAQVI
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 NW EXPRESSWAY APT 16096
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1603
Mailing Address - Country:US
Mailing Address - Phone:405-326-6929
Mailing Address - Fax:
Practice Address - Street 1:4101 NW EXPRESSWAY APT 16096
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1603
Practice Address - Country:US
Practice Address - Phone:405-326-6929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians