Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 18541 | OK |
N | 111NI0900X | Internist | 18541 | OK |
N | 207RH0000X | Hematologist | 18541 | OK |
Y | 207RH0003X | Hematology & Oncology | 18541 | OK |
N | 207RX0202X | Medical Oncology | 18541 | OK |
NPI | 1114974466 |
---|---|
Provider Name | Dr. Romeo Ang Mandanas |
First Address | Oklahoma City, OK 73112-5556 |
Second Address | Oklahoma City, OK 73142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 27/06/2017 |