MITWALLI, MAISSA BAKER - Licensee Information

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

MITWALLI, MAISSA BAKER

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:	THE ORTHOPEDIC CENTER 1809 EAST 13TH ST TULSA OK 74104 Address last updated on 5/17/2024
Phone #:
Fax #:
County:	TULSA
License:	4400
Dated:	11/4/2020
Expires:	3/31/2025
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
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.

Locations:	Hours:	Languages:
THE ORTHOPEDIC CENTER 1809 EAST 13TH ST TULSA OK 74104 Phone #: Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
YOGESH MITTAL	MD	23844
ELIZABETH S. MONNOT	DO	3591

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