Medi Practice Management LLC
Internal Medicine in Edmond, OK. Organization (NPI-2).
NPI number1962024893
StatusActive
Last updated in NPPESMay 14, 2020
Details
- NPI
- 1962024893
- Entity type
- Organization (NPI-2)
- Legal business name
- Medi Practice Management LLC
- Organization subpart
- No
- Enumeration date
- May 14, 2020
- Certification date
- May 14, 2020
- Last updated
- May 14, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
3008 Nw 168th CtEdmond, OK 73012-6787
Phone 580-210-0040
Mailing address
3008 Nw 168th CtEdmond, OK 73012-6787
Phone 580-210-0040 · Fax 405-330-9082
Authorized official
Samina Anwar
Owner
5802100040
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