Provider Demographics
NPI:1568456499
Name:MALATI, HANI RAMZI (MD)
Entity Type:Individual
Prefix:DR
First Name:HANI
Middle Name:RAMZI
Last Name:MALATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S BELMONT AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-6315
Mailing Address - Country:US
Mailing Address - Phone:918-756-9271
Mailing Address - Fax:918-756-4695
Practice Address - Street 1:1101 S BELMONT AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6315
Practice Address - Country:US
Practice Address - Phone:918-756-9271
Practice Address - Fax:918-756-4695
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14985207Y00000X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100031430AMedicaid
OK100031430AMedicaid