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Individual

DR. KIMBO BELLO SANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2510 E INDEPENDENCE ST STE 102, SHAWNEE, OK 74804-1839
(678) 697-9315
Mailing address
12552 CRICK HOLLOW CT, OKLAHOMA CITY, OK 73170-2076

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43390
OK
208M00000X
Hospitalist Physician
43390
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201299480A
OK
01
43390
LICENSE
OK
Enumeration date
04/09/2021
Last updated
11/27/2024
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