Provider Demographics
NPI:1548252299
Name:RAMADAN, TAWFIK (MD)
Entity type:Individual
Prefix:
First Name:TAWFIK
Middle Name:
Last Name:RAMADAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 ARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4045
Mailing Address - Country:US
Mailing Address - Phone:580-436-2283
Mailing Address - Fax:580-436-2291
Practice Address - Street 1:1214 ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4045
Practice Address - Country:US
Practice Address - Phone:580-436-2283
Practice Address - Fax:580-436-2291
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11462174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE11792Medicare UPIN