Provider Demographics
NPI:1811189194
Name:FUHRMEISTER, PAUL KONRAD (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:KONRAD
Last Name:FUHRMEISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:918-542-3900
Mailing Address - Fax:918-542-3928
Practice Address - Street 1:21 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6815
Practice Address - Country:US
Practice Address - Phone:918-542-3900
Practice Address - Fax:918-542-3928
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200170520AMedicaid
OK100736700OMedicaid
OK9135052Medicaid
OKH54540Medicare UPIN
OK403104Medicare PIN
OK100736700OMedicaid
OK900522214Medicare PIN