Basic Information
| Provider Information | |||||||||
| NPI: | 1932539491 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PRECISION INTERNAL MEDICINE CARE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3900 W BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | MUSKOGEE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 744012145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186828612 | ||||||||
| FaxNumber: | 9186820620 | ||||||||
| Practice Location | |||||||||
| Address1: | 3900 W BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | MUSKOGEE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 744012145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186828612 | ||||||||
| FaxNumber: | 9186820620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2013 | ||||||||
| LastUpdateDate: | 11/20/2013 | ||||||||
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| AuthorizedOfficialLastName: | ALMOUNAJJED | ||||||||
| AuthorizedOfficialFirstName: | AZZAM | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9186828612 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 26649 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.