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Individual

DR. BOMMASAMUDRAM ASHWINI KUMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
215 N MIDWEST BLVD, MIDWEST CITY, OK 73110-4320
(405) 737-3491
(405) 737-5956
Mailing address
215 N MIDWEST BLVD, MIDWEST CITY, OK 73110-4320
(405) 737-3491
(405) 737-5956

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
25189
OK
207X00000X
Orthopaedic Surgery Physician
Primary
25189
OK
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25189
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200096480A
OK
Enumeration date
09/15/2006
Last updated
08/27/2020
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