Individual
CHARLES CARVAJAL TE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4050 W MEMORIAL RD FL 3, OKLAHOMA CITY, OK 73120-8382
(405) 608-3800
(405) 608-3831
Mailing address
7800 NW 85TH TER, OKLAHOMA CITY, OK 73132-3385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25661
OK
207RC0000X
Cardiovascular Disease Physician
25661
OK
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
25661
OK
207UN0901X
Nuclear Cardiology Physician
25661
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200192780A
—
OK
Enumeration date
06/22/2007
Last updated
06/06/2022
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