Individual
OMID ROOSTAEYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18503 N PORTLAND AVE, EDMOND, OK 73012-9149
(405) 531-4271
Mailing address
18503 N PORTLAND AVE, EDMOND, OK 73012-9149
(405) 531-4271
(405) 531-4272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37981
OK
Other
Enumeration date
04/10/2018
Last updated
07/20/2021
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