Individual
SANDEEP GAJANAN PRABHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 EVERETT DR, 1NP606, OKLAHOMA CITY, OK 73104-5047
(405) 271-5125
Mailing address
940 STANTON L YOUNG BLVD, BMSB 357, OKLAHOMA CITY, OK 73104-5020
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
25469
OK
Other
Enumeration date
03/04/2008
Last updated
03/04/2008
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