Provider Demographics
NPI:1811297260
Name:AMER B NOUH MD PLLC
Entity type:Organization
Organization Name:AMER B NOUH MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMER
Authorized Official - Middle Name:B
Authorized Official - Last Name:NOUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-869-2194
Mailing Address - Street 1:2601 GLEN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4287
Mailing Address - Country:US
Mailing Address - Phone:215-869-2194
Mailing Address - Fax:
Practice Address - Street 1:1417 NW 150TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1305
Practice Address - Country:US
Practice Address - Phone:405-418-4041
Practice Address - Fax:405-418-4136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK276052084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200312230AMedicaid