ASHTAMI VISHWANATH BANAVALI

ADA, OK
NPI1902184518
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207RH0003X Internal Medicine, Hematology & Oncology
(Licence: OK  32636)
Additional Taxonomies207R00000X Internal Medicine
(Licence: MD  P26486)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2011-07-31
Last Update Date2017-12-29
Business Address
Dr. ASHTAMI VISHWANATH BANAVALI MD
430 N MONTE VISTA ST
ADA, OK 74820-4610
Phone number: 580-421-1141
Mailing Address
Dr. ASHTAMI VISHWANATH BANAVALI MD
430 N MONTE VISTA ST
ADA, OK 74820-4610
Phone number: 580-421-1141