Individual
DR. SRINIVAS MAHESH KATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3501 W BROADWAY ST, MUSKOGEE, OK 74401-2138
(918) 913-9408
(888) 383-0122
Mailing address
2505 BACON CT, MUSKOGEE, OK 74403-1662
(732) 986-1758
(888) 383-0122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30949
OK
207R00000X
Internal Medicine Physician
MD61441562
WA
207RN0300X
Nephrology Physician
2012011844
MO
207RN0300X
Nephrology Physician
Primary
30949
OK
208M00000X
Hospitalist Physician
2020041626
MO
208M00000X
Hospitalist Physician
27938
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200566560A
—
OK
Enumeration date
06/30/2009
Last updated
08/25/2023
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