Provider Demographics
NPI:1316469109
Name:ALI MOHAMED ELSAYED, RAZAN (MD)
Entity type:Individual
Prefix:DR
First Name:RAZAN
Middle Name:
Last Name:ALI MOHAMED ELSAYED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RAZAN
Other - Middle Name:
Other - Last Name:ELSAYED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:800 STANTON L YOUNG BLVD # 5481
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5018
Mailing Address - Country:US
Mailing Address - Phone:405-271-4742
Mailing Address - Fax:
Practice Address - Street 1:800 STANTON L YOUNG BLVD # 5481
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5018
Practice Address - Country:US
Practice Address - Phone:405-271-4742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK36009207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program