Organization
GREAT PLAINS CARDIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAKESH SHRIVASTAVA MD (OWNER)
(405) 642-8613
Entity
Organization
Contact information
Practice address
105 S BRYANT AVE STE 101, EDMOND, OK 73034-6330
(405) 861-0004
(855) 680-8890
Mailing address
PO BOX 8350, EDMOND, OK 73083-8350
(405) 861-0004
(855) 680-8890
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Enumeration date
11/09/2021
Last updated
02/16/2022
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