Individual
DR. VENKATA RAMA GOPALA SRIHARSHA DAMERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
3315 KETHLEY RD, SHAWNEE, OK 74804-9638
(405) 273-5801
(405) 878-3814
Mailing address
PO BOX 849, SHAWNEE, OK 74802-0849
(405) 273-5801
(405) 878-3814
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
28396
OK
207RN0300X
Nephrology Physician
Primary
28396
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/11/2008
Last updated
06/11/2021
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