Individual
DR. AVANI SHETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4200 W MEMORIAL RD, STE 305, OKLAHOMA CITY, OK 73120-9350
(405) 841-7899
(405) 749-9779
Mailing address
3705 W MEMORIAL RD, STE 302, OKLAHOMA CITY, OK 73134-1506
(405) 775-9350
(405) 775-9360
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
14599
OK
208VP0000X
Pain Medicine Physician
Primary
14599
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050063896
MEDICARE RR
OK
05
—
100821950B
—
OK
01
—
208041773001
BC/BS
OK
01
—
P00424369
MEDICARE RR
OK
Enumeration date
06/13/2005
Last updated
07/09/2014
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