Healthcare Provider Details

I. General information

NPI: 1407816457
Provider Name (Legal Business Name): ANGELA L SCHUFF DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 W MEMORIAL RD SUITE 308
OKLAHOMA CITY OK
73120-8305
US

IV. Provider business mailing address

4200 W MEMORIAL RD SUITE 308
OKLAHOMA CITY OK
73120-8305
US

V. Phone/Fax

Practice location:
  • Phone: 405-755-2334
  • Fax: 405-755-7803
Mailing address:
  • Phone: 405-755-2334
  • Fax: 405-755-7803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number242
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: