Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 30484EFF | OK |
Y | 207RH0003X | Hematology & Oncology | 30484EFF | OK |
N | 207RX0202X | Medical Oncology | 30484EFF | OK |
NPI | 1033369988 |
---|---|
Provider Name | Dr. Susanna V. Ulahannan |
First Address | Ponca City, OK 74601-2911 |
Second Address | Ponca City, OK 74601-2911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2008 |
Last Update Date | 15/05/2015 |