Provider Demographics
NPI:1144295429
Name:STRANGE, MICHAEL WARREN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WARREN
Last Name:STRANGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1514 S RANGE RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-1097
Mailing Address - Country:US
Mailing Address - Phone:405-377-8432
Mailing Address - Fax:
Practice Address - Street 1:1202 W FARM RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74078-2000
Practice Address - Country:US
Practice Address - Phone:405-744-7016
Practice Address - Fax:405-744-6556
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12115207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE10006Medicare UPIN