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SUZANNE RENEE OLIVE MD

Allergy

Tulsa, Oklahoma

Provider NPI: 1679532170

Provider Information:
 SUZANNE RENEE OLIVE MD


Practice Location:
1725 E 19TH ST STE 200 TULSA, OK 74104 US
Tel: 918-748-8381  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207KA0200XPhysicians
Allergy & Immunology
Allergy
OK16883
N207RC0200XPhysicians
Internal Medicine
OK16883
Y207RP1001XPhysicians
Internal Medicine
OK16883
N207RS0012XPhysicians
Internal Medicine
OK16883

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELDH9006066300101
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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