Individual
DR. ALIREZA ABOLMAALI DAMGHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5251
(214) 392-7042
(405) 739-0335
Mailing address
1001 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5251
(214) 392-7042
(405) 739-0335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26582
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200203110A
—
OK
01
—
OK401155
MEDICARE PTAN
OK
Enumeration date
04/19/2007
Last updated
10/08/2010
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