Individual
NIKET MUNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-5238
Mailing address
921 NE 13TH ST, VETERANS AFFAIRS, DEPARTMENT OF GERIATRICS, 4B-113O, OKLAHOMA CITY, OK 73104
(405) 456-5114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
30894
OK
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
30894
OK
Other
Enumeration date
07/16/2014
Last updated
09/12/2025
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