Healthcare Provider Details

I. General information

NPI: 1376117408
Provider Name (Legal Business Name): GEORGE YIN-NYEYA WUNI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 NE 13TH ST # 1200
OKLAHOMA CITY OK
73117-1039
US

IV. Provider business mailing address

1122 NE 13TH ST # 1200
OKLAHOMA CITY OK
73117-1039
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8558
  • Fax:
Mailing address:
  • Phone: 405-271-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA12331100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: