MEDICARE: MIDWEST SLEEP LAB LLC

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1538159215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST SLEEP LAB LLC

Provider Business Mailing Address
First Line	:	PO BOX 26485
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73126-0485
Country	:	US
Telephone Number	:	405-455-5052
Fax Number	:	405-455-4142

Provider Business Practice Location Address
First Line	:	8121 NATIONAL AVE
Second Line	:	SUITE 208
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-7530
Country	:	US
Telephone Number	:	405-455-5052
Fax Number	:	405-455-4142

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. ASIM JAFAR CHOHAN
Credential	:	M.D.
Telephone Number	:	405-610-7057

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	08/22/2020

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Directions to “MIDWEST SLEEP LAB LLC ” Practice Location

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