MEDICARE: DR. PETER MESSIAH

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1679992465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER MESSIAH

Provider Business Mailing Address
First Line	:	5317 CHARITY LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73121-5008
Country	:	US
Telephone Number	:	832-215-8527
Fax Number	:

Provider Business Practice Location Address
First Line	:	5317 CHARITY LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73121-5008
Country	:	US
Telephone Number	:	832-215-8527
Fax Number	:

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

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	04/09/2014

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Directions to “ DR. PETER MESSIAH ” Practice Location

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