Individual
JALAL SHARIAT MOHARRERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 585-5545
Mailing address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 585-5548
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
15896
FL
207Q00000X
Family Medicine Physician
Primary
6217
OK
Other
Enumeration date
06/13/2016
Last updated
06/05/2019
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