Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 26220 | OK |
NPI | 1043421555 |
---|---|
Provider Name | Madona Azar |
First Address | Oklahoma City, OK 73104-3252 |
Second Address | Oklahoma City, OK 73104-3252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 15/03/2011 |