Individual
SUZANNE RENEE OLIVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1725 E 19TH ST, STE 200, TULSA, OK 74104-5415
(918) 748-8381
(918) 748-8397
Mailing address
1515 N HARVARD AVE, STE E, TULSA, OK 74115-4957
(918) 832-6049
(918) 832-6055
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
16883
OK
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
16883
OK
207RP1001X
Pulmonary Disease Physician
Primary
16883
OK
207RS0012X
Sleep Medicine (Internal Medicine) Physician
16883
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H90060663001
BLUE CROSS BLUE SHIELD
—
Enumeration date
03/22/2006
Last updated
11/10/2015
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