Organization
SHOOLIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAKESH SHRIVASTAVA MD (OWNER)
(405) 642-8613
Entity
Organization
Contact information
Practice address
105 S BRYANT AVE STE 101, EDMOND, OK 73034-6330
(405) 861-0004
(855) 680-8890
Mailing address
PO BOX 8350, EDMOND, OK 73083-8350
(405) 861-0004
(855) 680-8890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27981
OK
207RC0000X
Cardiovascular Disease Physician
27981
OK
207RI0011X
Interventional Cardiology Physician
27981
OK
208M00000X
Hospitalist Physician
Primary
27981
OK
Other
Enumeration date
09/25/2017
Last updated
02/16/2022
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