Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 24624 | OK |
NPI | 1093784746 |
---|---|
Provider Name | Umakumaram P Ponniah |
First Address | Oklahoma City, OK 73117-1039 |
Second Address | Oklahoma City, OK 73104-4600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 14/01/2011 |