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DI BLASI, MICHELE       
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.
Practice Address: 4417 WEST GORE BLVD
SUITE 5
LAWTON OK 73505-5978

Address last updated on 7/14/2003
Phone #:
Fax #: (580) 353-3311
County: COMANCHE
License: 20661
Dated: 8/10/1998
Expires: 8/1/2002
License Type: Medical Doctor
Specialty: Cardiovascular Disease
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Di Firenze, Fac Di Med E Chirurgia, Firenze, Italy
Graduated: 10 / 1988
CME Year: 2004
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
4417 WEST GORE BLVD
SUITE 5
LAWTON OK 73505-5978

Phone #:
Fax #: (580) 353-3311

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