Provider Demographics
NPI:1073209300
Name:KORUTHU, SHEEBA S (MD)
Entity Type:Individual
Prefix:
First Name:SHEEBA
Middle Name:S
Last Name:KORUTHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEEBA
Other - Middle Name:S
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7501 RIVERSIDE PKWY
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5056
Mailing Address - Country:US
Mailing Address - Phone:918-710-4200
Mailing Address - Fax:918-403-6331
Practice Address - Street 1:7501 RIVERSIDE PKWY
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5056
Practice Address - Country:US
Practice Address - Phone:918-710-4200
Practice Address - Fax:918-403-6331
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program