Healthcare Provider Details

I. General information

NPI: 1376011478
Provider Name (Legal Business Name): MIDWEST HOSPITALIST GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E 19TH ST
EDMOND OK
73013-6618
US

IV. Provider business mailing address

PO BOX 96408
OKLAHOMA CITY OK
73143-6408
US

V. Phone/Fax

Practice location:
  • Phone: 405-367-6180
  • Fax:
Mailing address:
  • Phone: 405-367-6180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD SANAULLAH
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 405-367-6180