MEDICARE: DR. ADEL RAMZI MALATI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	18853	OK
2	207R00000X	Internal Medicine Physician	35067408M	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740286467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADEL RAMZI MALATI M.D.

Provider Business Mailing Address
First Line	:	1201 S BELMONT
Second Line	:	SUITE #101
City	:	OKMULGEE
State	:	OK
Zip	:	74447
Country	:	US
Telephone Number	:	918-756-2800
Fax Number	:	918-756-2861

Provider Business Practice Location Address
First Line	:	1201 S BELMONT
Second Line	:	SUITE #101
City	:	OKMULGEE
State	:	OK
Zip	:	74447
Country	:	US
Telephone Number	:	918-756-2800
Fax Number	:	918-756-2861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	05/17/2012

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Directions to “ DR. ADEL RAMZI MALATI M.D.” Practice Location

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