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Contact Information

MICAELA LUPOV, PA
101 N ROBINSON AVE STE 200
OKLAHOMA CITY, OK73102
 Phone: 405-271-8880
 Fax: 405-208-8732
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MICAELA LUPOV · (Female)

NPI Number 1700263928
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 04/27/2015
Last updated 08/27/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 2497
  • OK Medicaid 100748790A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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