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NPI Code Detail

MEDICARE: SIDRA MEMON M.D.

MEDICARE: SIDRA MEMON M.D.
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
1207RR0500XRheumatology Physician47687OK

General Provider Information

NPI Number : 1861196164
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIDRA MEMON M.D.
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 : 405-271-6400
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 : 405-271-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2023
Last Update Date : 05/06/2026

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