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Organization
PREMIUM ENTERPRISES INC
Active
Organization
PREMIUM ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD GHIAS MD (OWNER)
(855) 541-2862
Entity
Organization
Contact information
Practice address
1104 E STATE HIGHWAY 152 UNIT 1, MUSTANG, OK 73064-5116
(855) 541-2862
(405) 716-4808
Mailing address
15509 JUNIPER DR, EDMOND, OK 73013-8841
(855) 541-2862
(405) 716-4808
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
22910
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200080810A
—
OK
Enumeration date
08/22/2017
Last updated
08/22/2017
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