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NPI Code Detail

MEDICARE: DR. RALPH OSCAR SHADID M.D.

MEDICARE: DR. RALPH OSCAR SHADID 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
1207R00000XInternal Medicine Physician13215OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2080005669OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922091511
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RALPH OSCAR SHADID M.D.
Provider Business Mailing Address
First Line : 5300 N INDEPENDENCE AVE
Second Line : SUITE 280
City : OKLAHOMA CITY
State : OK
Zip : 73112-5556
Country : US
Telephone Number : 405-713-7403
Fax Number : 405-713-2794
Provider Business Practice Location Address
First Line : 4401 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3413
Country : US
Telephone Number : 405-713-7403
Fax Number : 405-713-2794
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 07/20/2017

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