Provider Demographics
NPI:1679992465
Name:MESSIAH, PETER
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:MESSIAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 CHARITY LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73121-5008
Mailing Address - Country:US
Mailing Address - Phone:832-215-8527
Mailing Address - Fax:
Practice Address - Street 1:5317 CHARITY LN
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73121-5008
Practice Address - Country:US
Practice Address - Phone:832-215-8527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management