Basic Information
Provider Information
NPI: 1619231073
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIMA
FirstName: HAMID
MiddleName: REZA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5300 N INDEPENDENCE AVE STE 280
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731125555
CountryCode: US
TelephoneNumber: 4059493349
FaxNumber:  
Practice Location
Address1: 3300 NW EXPRESSWAY
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731124418
CountryCode: US
TelephoneNumber: 4059493349
FaxNumber: 4059455647
Other Information
ProviderEnumerationDate: 06/30/2012
LastUpdateDate: 06/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0008X34836OKY Allopathic & Osteopathic PhysiciansInternal MedicineHepatology

No ID Information.


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