Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 13913 | OK |
Y | 208600000X | Surgeon | 13913 | OK |
N | 2082S0105X | Plastic Hand Surgeon | 13913 | OK |
NPI | 1205836491 |
---|---|
Provider Name | Mehdi Navid Adham |
First Address | Oklahoma City, OK 73139-9402 |
Second Address | Oklahoma City, OK 73139-9475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 10/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13913 | MEDICAL LICENSE (01) | OK |
D05826 | (02) | OK |