MEDICARE: OMER SUHAIB 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
1	2084N0400X	Neurology Physician	2021-01526	NC
2	2084N0400X	Neurology Physician	3719	WI
3	2084N0400X	Neurology Physician	30031	OK

General Provider Information

NPI Number	:	1336589548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OMER SUHAIB MD

Provider Business Mailing Address
First Line	:	5300 N INDEPENDENCE AVE STE 280
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5555
Country	:	US
Telephone Number	:	405-713-9930
Fax Number	:	405-713-9931

Provider Business Practice Location Address
First Line	:	3366 NW EXPRESSWAY STE 200
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112
Country	:	US
Telephone Number	:	405-713-9930
Fax Number	:	405-713-9931

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2013
Last Update Date	:	12/18/2025

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