Provider Demographics
NPI:1972098242
Name:QAISER, IMAN (MD)
Entity type:Individual
Prefix:DR
First Name:IMAN
Middle Name:
Last Name:QAISER
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 1:1801 CHUKKA HINA
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-7117
Mailing Address - Country:US
Mailing Address - Phone:918-567-7140
Mailing Address - Fax:918-567-7113
Practice Address - Street 1:1801 CHUKKA HINA
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-7117
Practice Address - Country:US
Practice Address - Phone:918-567-7140
Practice Address - Fax:918-567-7113
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351035217207R00000X
MI4301115810207R00000X
OK40195207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine