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Individual

MERRY MATHEW THENMADATHIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9900 BROADWAY EXT STE 200, OKLAHOMA CITY, OK 73114-6323
(405) 608-8833
(405) 608-8188
Mailing address
9900 BROADWAY EXT STE 200, OKLAHOMA CITY, OK 73114-6323
(405) 608-8833
(405) 608-8188

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
011540
NY
363AM0700X
Medical Physician Assistant
Primary
1857
OK

Other

Enumeration date
01/02/2007
Last updated
07/28/2025
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