Individual
EVGENY VADIMOVICH SIDOROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
711 STANTON L YOUNG BLVD, PPB 215, OKLAHOMA CITY, OK 73104-5023
(405) 271-4113
Mailing address
940 STANTON L YOUNG BLVD, BMSB 357, OKLAHOMA CITY, OK 73104-5020
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
24894
OK
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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