Healthcare Provider Details

I. General information

NPI: 1154740645
Provider Name (Legal Business Name): ALI CHEEMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

6600 S YALE AVE STE 1200
TULSA OK
74136-3333
US

V. Phone/Fax

Practice location:
  • Phone: 918-502-1900
  • Fax:
Mailing address:
  • Phone: 918-488-6653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35926
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: