Individual
SARAH ANNE THEVATHERIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
940 NE 13TH ST # 2300, OKLAHOMA CITY, OK 73104-5008
(405) 271-2429
Mailing address
940 NE 13TH ST # 2300, OKLAHOMA CITY, OK 73104-5008
(405) 271-2429
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2019022811
MO
208000000X
Pediatrics Physician
94-10019
KS
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
39657
OK
Other
Enumeration date
04/10/2019
Last updated
05/16/2022
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