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NPI Code Detail

MEDICARE: MICHELLE BOAMAH MD

MEDICARE: MICHELLE BOAMAH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramOK

General Provider Information

NPI Number : 1174379127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE BOAMAH MD
Provider Business Mailing Address
First Line : 800 STANTON L YOUNG BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73104-5018
Country : US
Telephone Number : 405-271-5504
Fax Number :
Provider Business Practice Location Address
First Line : 800 STANTON L YOUNG BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73104-5018
Country : US
Telephone Number : 405-271-5504
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2024
Last Update Date : 05/12/2026

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Directions to “ MICHELLE BOAMAH MD” Practice Location

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