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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST
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PEDULLA, DOMINIC MARION
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This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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| Practice Address: |
3330 NW 56TH ST. SUITE 622
OKLAHOMA CITY OK 73112
Address last updated on 3/3/2023 |
| Phone #: |
(405) 947-2228 |
| Fax #: |
(405) 947-2307 |
| County: |
OKLAHOMA |
| License: |
17642 |
| Dated: |
5/18/1991 |
| Expires: |
5/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Cardiovascular Disease
Phlebology
Internal Medicine |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
NEW YORK MED COLL, VALHALLA NY 10595 |
| Graduated: |
5 /
1986 |
| CME Year: |
2025 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
ABPS - Internal Medicine
AMERICAN BOARD OF INTERNAL MEDICINE |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
None listed |
| Hospital Privileges: |
INTEGRIS Baptist Medical Center
Oklahoma City, OK
Mercy Hospital OKC
Oklahoma City, OK
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Primary Supervisees(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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JAMES CAMERON HOGAN
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PA |
1816 |
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