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Oklahoma Board of Medical Licensure and Supervision

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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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NSA, MUSHENI       
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: 4023 NW 10TH ST
OKLAHOMA CITY OK 73107

Address last updated on 6/12/2024
Phone #:
Fax #:
County: OKLAHOMA
License: 35049
Dated: 7/10/2019
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Pediatrics
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of NC Chapel Hill Sch Of Med, Chapel Hill Nc 27599
Graduated: 5 / 2011
CME Year: 2025
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: AMERICAN BOARD OF PEDIATRICS
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
4023 NW 10TH ST
OKLAHOMA CITY OK 73107

Phone #:
Fax #:
Mon: 7:00AM - 5:00PM
Tue: 7:00AM - 5:00PM
Wed:
Thu:
Fri:
Sat:
Sun:

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