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Individual

VERAPAN VONGTHAVARAVAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4811 GAILLARDIA PKWY STE 200, OKLAHOMA CITY, OK 73142-1874
(405) 751-4199
(405) 607-1848
Mailing address
4811 GAILLARDIA PKWY STE 200, OKLAHOMA CITY, OK 73142-1874
(405) 751-4199
(405) 607-1848

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
21093
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1017VA
REGENCE BLUE SHIELD
WA
05
213563
OR
01
5166925
PPNI
WA
01
5741926
FIRST HEALTH CCN COVENTRY
WA
01
7605381
AETNA
WA
05
8428732
WA
01
9395857
PCHS MULTIPLAN
WA
Enumeration date
03/08/2007
Last updated
07/11/2011
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