Individual
SHEBA MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9001 S WESTERN AVE, OKLAHOMA CITY, OK 73139-2722
(405) 691-6620
Mailing address
9001 S WESTERN AVE, OKLAHOMA CITY, OK 73139-2722
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15249
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100235980A
—
OK
Enumeration date
09/30/2022
Last updated
09/30/2022
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