Provider Demographics
NPI:1760048045
Name:HARVEY, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HARVEY
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 1:1121 NW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:NICHOLS HILLS
Mailing Address - State:OK
Mailing Address - Zip Code:73116-6504
Mailing Address - Country:US
Mailing Address - Phone:405-652-0632
Mailing Address - Fax:405-652-0598
Practice Address - Street 1:1121 NW 63RD ST
Practice Address - Street 2:
Practice Address - City:NICHOLS HILLS
Practice Address - State:OK
Practice Address - Zip Code:73116-6504
Practice Address - Country:US
Practice Address - Phone:405-652-0632
Practice Address - Fax:405-652-0598
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK39725207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine