Organization
MICHAEL D ELDER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DREW ELDER M.D. (OWNER)
(405) 272-9644
Entity
Organization
Contact information
Practice address
1111 N LEE AVE, SUITE 236, OKLAHOMA CITY, OK 73103-2600
(405) 272-9644
(405) 272-0361
Mailing address
1111 N LEE AVE, SUITE 236, OKLAHOMA CITY, OK 73103-2600
(405) 272-9644
(405) 272-0361
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
14210
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050090950
RR MEDICARE
—
01
—
235485700
DEPT OF LABOR
OR
Enumeration date
03/31/2008
Last updated
03/31/2008
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