Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 34535 | OK |
NPI | 1124382148 |
---|---|
Provider Name | Dr. Shashank Prakash Behere |
First Address | Oklahoma City, OK 73104-5047 |
Second Address | Oklahoma City, OK 73104-5047 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 08/11/2021 |