Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | F-014 | OK |
NPI | 1083195267 |
---|---|
Provider Name | Mohammed F Felemban |
First Address | Oklahoma City, OK 73117-1214 |
Second Address | Oklahoma City, OK 73117-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2018 |
Last Update Date | 24/08/2018 |