Dehadrai, Gautam

Dehadrai, Gautam is an individual health care provider with primary practice located at 901 N Porter Ave , Norman OK 73071-6404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Dehadrai, Gautam can be contacted via phone (405) 307-1600.

Contact Information

Primary practice address
901 N Porter Ave Norman OK 73071-6404
Fax: (405) 307-1604
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 2003-0258 New Mexico

Profile Details

NPI number 1982653424
LBN Legal business name Dehadrai, Gautam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Mar 10th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982653424 NPPES
Oklahoma MEDICAID 200050770A

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