| Comprehensive Infectious Disease Center Pc | |
|
8803 S 101st East Ave Suite 350 Tulsa OK 74133-5726 | |
| (918) 615-3750 | |
| Not Available |
| Full Name | Comprehensive Infectious Disease Center Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8803 S 101st East Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Peter Okwuasaba (OWNER OPERATOR) |
| Authorized Official Contact | 9186153750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Infectious Disease Center Pc 8803 S 101st East Ave Suite 350 Tulsa OK 74133-5726 Ph: (918) 615-3750 | Comprehensive Infectious Disease Center Pc 8803 S 101st East Ave Suite 350 Tulsa OK 74133-5726 Ph: (918) 615-3750 |
| NPI Number | 1639394331 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 07/14/2010 |
| Medicare PECOS PAC ID | 6709987613 |
|---|---|
| Medicare Enrollment ID | O20070723000351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639394331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Peter A Okwuasaba |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497803209 PECOS PAC ID: 7810098720 Enrollment ID: I20070723000328 |
| Provider Name | Adekemi Taiwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003397332 PECOS PAC ID: 0840537916 Enrollment ID: I20190128001754 |
| Provider Name | Queen Erue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659955771 PECOS PAC ID: 1759780554 Enrollment ID: I20210527002032 |
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