Provider Demographics
NPI:1528402898
Name:ASHRAF, SAMIRAH MUNIR (MD)
Entity Type:Individual
Prefix:
First Name:SAMIRAH
Middle Name:MUNIR
Last Name:ASHRAF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751
Mailing Address - Street 2:
Mailing Address - City:HULBERT
Mailing Address - State:OK
Mailing Address - Zip Code:74441-0751
Mailing Address - Country:US
Mailing Address - Phone:918-772-3390
Mailing Address - Fax:918-772-3638
Practice Address - Street 1:1310 E BOONE ST
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3338
Practice Address - Country:US
Practice Address - Phone:918-456-7700
Practice Address - Fax:918-458-9312
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA76286208000000X
OK33800208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics