Provider Demographics
NPI:1164428215
Name:HAMRA, MARK STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:STEVEN
Last Name:HAMRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9913 S 87TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5593
Mailing Address - Country:US
Mailing Address - Phone:918-250-0087
Mailing Address - Fax:918-258-1266
Practice Address - Street 1:817 S ELM PL
Practice Address - Street 2:STE 107
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5369
Practice Address - Country:US
Practice Address - Phone:918-259-3141
Practice Address - Fax:918-258-1266
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2022-12-18
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Provider Licenses
StateLicense IDTaxonomies
OK17578207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKF49200Medicare UPIN