Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 40036 | IA |
N | 2080P0203X | Pediatric Critical Care Doctor | 35095065 | OH |
NPI | 1124140009 |
---|---|
Provider Name | Muayyad Tailounie |
First Address | Oklahoma City, OK 73126-0901 |
Second Address | Oklahoma City, OK 73104-5036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 18/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000674768 | ANTHEM (01) | OH |
06959 | PARAMOUNT (01) | OH |
3057141 | (05) | OH |
69879 | HEALTH PLAN OF MICHIGAN (01) | OH |
9250345 | AETNA (01) | OH |