Individual
TAREK A DERNAIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13313 N MERIDIAN AVE, BUILDING D, OKLAHOMA CITY, OK 73120-8380
(405) 755-4290
(405) 755-7773
Mailing address
4401 W MEMORIAL RD, OKLAHOMA CITY, OK 73134-1785
(405) 752-3162
(405) 936-5211
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
23760
OK
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
23760
OK
207RP1001X
Pulmonary Disease Physician
Primary
23760
OK
207RS0012X
Sleep Medicine (Internal Medicine) Physician
23760
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200105550B
—
OK
01
—
P00763891
RAILROAD MEDICARE
—
Enumeration date
01/16/2007
Last updated
04/28/2014
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