Provider Demographics
NPI:1326149048
Name:DAHER, NADIM N (MD)
Entity Type:Individual
Prefix:
First Name:NADIM
Middle Name:N
Last Name:DAHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NADIM
Other - Middle Name:NADIM
Other - Last Name:DAHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2401 SOUTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-2726
Mailing Address - Country:US
Mailing Address - Phone:918-561-5701
Mailing Address - Fax:918-561-1173
Practice Address - Street 1:802 S JACKSON AVE STE 310
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9057
Practice Address - Country:US
Practice Address - Phone:918-631-8130
Practice Address - Fax:918-631-8134
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24335207RP1001X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200095140BMedicaid
OK289678YMSDOtherMEDICARE
OKOK700260Medicare PIN
OKOK402511Medicare PIN
OK200095140AMedicaid