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General NPI Number Information
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NPI Number | 1922355221
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Entity Type | Organization
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Legal Business Name | MERCY URGENT MEDICAL CENTER LLC
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 12/21/2012
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Provider Practice Location Address
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Address Line | 1228 SW 44TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-3604
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Country | US
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Telephone | 580-583-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 SW 44TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-3604
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. MOHAMMAD A AZEEM
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Credential | MD
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Telephone | 580-583-4760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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