Individual
DR. MOMEN BANIFADEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 502-1900
(918) 494-6303
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
40273
OK
207RP1001X
Pulmonary Disease Physician
Primary
40273
OK
Other
Enumeration date
09/04/2017
Last updated
07/10/2023
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