Healthcare Provider Details

I. General information

NPI: 1811410731
Provider Name (Legal Business Name): MR. MUIZ AJIBOLA KARIM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12724 N MACARTHUR BLVD APT I
OKLAHOMA CITY OK
73142-2914
US

IV. Provider business mailing address

12724 N MACARTHUR BLVD APT I
OKLAHOMA CITY OK
73142-2914
US

V. Phone/Fax

Practice location:
  • Phone: 405-430-5524
  • Fax:
Mailing address:
  • Phone: 405-430-5524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number37V617670815
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: