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Individual

VENKATESH MOVVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6565 S YALE AVE, #212, TULSA, OK 74136
(918) 502-4000
(918) 502-4001
Mailing address
6565 S YALE AVE, #212, TULSA, OK 74136
(918) 502-4000
(918) 502-4001

Taxonomy

Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
20519
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103863500
WC STATE OF OK
OK
01
7999176
AETNA
Enumeration date
07/21/2006
Last updated
04/22/2008
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