Individual
DOUGLAS MUKOROMBINDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5400 E MEMORIAL RD, EDMOND, OK 73013-8213
(405) 459-7016
Mailing address
5400 E MEMORIAL RD, EDMOND, OK 73013-8213
(405) 459-7016
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28214779A
IN
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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