Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 229451 | NY |
Y | 207RC0000X | Internist - Cardiovascular Disease | 24739 | OK |
NPI | 1003990540 |
---|---|
Provider Name | Sunil Thomas Mathew |
First Address | Norman, OK 73072-9801 |
Second Address | Norman, OK 73072-9801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 16/07/2021 |