Individual
DIANNE BREWER GASBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4200 W MEMORIAL RD, STE 405, OKLAHOMA CITY, OK 73120-9350
(405) 292-5500
(405) 292-5505
Mailing address
4200 W MEMORIAL RD, STE 405, OKLAHOMA CITY, OK 73120-9350
(405) 292-5500
(405) 292-5505
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
13952
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10002019OA
—
OK
01
—
P00149574
RAILROAD MEDICARE
OK
Enumeration date
08/16/2005
Last updated
11/08/2012
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