IndividualActive
Qaisar Qayyum, M.D.
NPI 1720025448 · Geriatric Medicine (Internal Medicine) Physician · Edmond, OK
Provider details
- NPI number
- 1720025448
- Entity type
- Individual
- Primary specialty
- Geriatric Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 21912 (OK)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
13974 S Broadway
Edmond, OK 73034-8144
Phone: (405) 562-8715
Fax: (405) 562-8717
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 31195
Edmond, OK 73003-0020
Registry dates
- Enumerated
- 2006-06-01
- Last updated
- 2020-06-22
- Certified
- 2020-06-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.