Individual
DR. SHILPA SUSAN SANTHOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6116 S LEWIS AVE, TULSA, OK 74136-1001
(918) 742-1643
Mailing address
6116 S LEWIS AVE, TULSA, OK 74136-1001
(918) 742-1643
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19036
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19036
PHARMACIST STATE LICENSE
OK
Enumeration date
12/11/2020
Last updated
12/11/2020
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