Individual
DR. MOUTASIM HOMOD AL-SHAER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
6600 S YALE AVE, SUITE 1400, TULSA, OK 74136-3347
(918) 488-6001
(918) 488-6010
Mailing address
10501 E 91ST ST, TULSA, OK 74133-5790
(918) 502-1900
(918) 494-6303
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26873
OK
208M00000X
Hospitalist Physician
Primary
26873
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1239726
CONTROLLED SUBSTANCE REG.
IA
05
—
20024424DA
—
OK
01
—
CD1018
RAILROAD MEDICARE
IA
Enumeration date
06/08/2006
Last updated
11/04/2013
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