Healthcare Provider Details

I. General information

NPI: 1326477167
Provider Name (Legal Business Name): NYAME PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 W SIERRA SPRINGS DR
EDMOND OK
73012-9072
US

IV. Provider business mailing address

2625 W SIERRA SPRINGS DR
EDMOND OK
73012-9072
US

V. Phone/Fax

Practice location:
  • Phone: 615-975-7660
  • Fax: 405-601-7012
Mailing address:
  • Phone: 615-975-7660
  • Fax: 405-601-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number29099
License Number StateOK

VIII. Authorized Official

Name: ALEX DWUMA
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 615-975-7660