Provider Information for 1316481054
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GODLOVE CHUU GWAABE BA
Sex: Male
NPI: 1316481054
Last Updated: 2021-06-17
Certification Date: 2021-06-17
Certification Date: 2021-06-17
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316481054 | ||||||||||||
| Enumeration Date | 2016-12-15 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1330 N CLASSEN BLVD STE 214 OKLAHOMA CITY, OK 73106-6834 United States Phone: 405-601-6710 | Fax:405-601-6711 | ||||||||||||
| Primary Practice Address | 1330 N CLASSEN BLVD STE 214 OKLAHOMA CITY, OK 73106-6834 United States Phone: 405-601-6710 | Fax:405-601-6711 | ||||||||||||
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