Provider Demographics
NPI:1356667372
Name:MASHEGU, HAFSAT UMAR (MD)
Entity Type:Individual
Prefix:
First Name:HAFSAT
Middle Name:UMAR
Last Name:MASHEGU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HAFSAT
Other - Middle Name:OMAR
Other - Last Name:MOHAMMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5217 S VANDALIA AVE
Mailing Address - Street 2:APT 1C
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-4058
Mailing Address - Country:US
Mailing Address - Phone:770-994-0420
Mailing Address - Fax:770-994-0420
Practice Address - Street 1:4502 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-9923
Practice Address - Country:US
Practice Address - Phone:918-660-3416
Practice Address - Fax:918-660-3426
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27719208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics