Provider Demographics
NPI:1447614524
Name:MOHAMED ALI, ABDEL-MONEIM (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDEL-MONEIM
Middle Name:
Last Name:MOHAMED ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MONEIM
Other - Middle Name:
Other - Last Name:ELOMEIRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MBBS
Mailing Address - Street 1:800 STANTON L LONG BOULEVARD
Mailing Address - Street 2:SUITE 8300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5417
Mailing Address - Country:US
Mailing Address - Phone:405-271-2220
Mailing Address - Fax:
Practice Address - Street 1:825 NE 10TH STREET
Practice Address - Street 2:OUP 1703
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK39365208600000X, 208200000X
MD390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program