Healthcare Provider Details

I. General information

NPI: 1972350197
Provider Name (Legal Business Name): DOAA ALTAMEEMI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 05/06/2024
Certification Date: 05/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 W 6TH AVE
STILLWATER OK
74074-4399
US

IV. Provider business mailing address

4599 N WASHINGTON ST APT 14G
STILLWATER OK
74075-1293
US

V. Phone/Fax

Practice location:
  • Phone: 405-784-5842
  • Fax:
Mailing address:
  • Phone: 405-762-5582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number43436
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: