Individual
GOPAKUMAR B DAMAYANTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8855 E RENO AVE, MIDWEST CITY, OK 73110-7729
(405) 610-3048
Mailing address
8855 E RENO AVE, MIDWEST CITY, OK 73110-7729
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1257
OK
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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