Individual
MS. MAISSA BAKER MITWALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2431 E 61ST ST STE 500, TULSA, OK 74136-1208
(918) 582-6800
(918) 582-6060
Mailing address
2431 E 61ST ST STE 500, TULSA, OK 74136-1208
(918) 582-6800
(918) 582-6060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/07/2020
Last updated
11/12/2024
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