Individual
MR. BEAREK DELAINE FUGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
319 A ST SW, MIAMI, OK 74354-7605
(918) 544-6424
Mailing address
827 O ST NW APT 3, MIAMI, OK 74354-2844
(918) 325-3768
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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