Individual
JENNIFER M MINADEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 748-7602
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 748-7602
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30846
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2011
Last updated
07/24/2014
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