Individual
NIDHI KOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2617 S. ELM PLACE, BROKEN ARROW, OK 74012-7850
(918) 455-6980
(918) 449-9749
Mailing address
2617 S. ELM PLACE, BROKEN ARROW, OK 74012-7850
(918) 455-6980
(918) 449-9749
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
224299
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000031938
BMC HEALTHNET PLAN
MA
01
—
0036582
NHP
MA
05
—
1300172
—
MA
05
—
200222490A
—
OK
01
—
3986470
AETNA
MA
01
—
412987
BC BS OF RI
RI
01
—
486892
TUFTS
MA
01
—
89793
CMSP
MA
01
—
AA40070
HARVARD PILGRIM
MA
01
—
J29428
BC BS OF MA
MA
Enumeration date
10/03/2006
Last updated
06/21/2011
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