Provider Demographics
NPI:1376506253
Name:GUNIGANTI, UMA MAHESWARI (MD)
Entity Type:Individual
Prefix:DR
First Name:UMA
Middle Name:MAHESWARI
Last Name:GUNIGANTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1127 E OWEN K GARRIOTT RD
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-6151
Mailing Address - Country:US
Mailing Address - Phone:580-234-7320
Mailing Address - Fax:580-234-5520
Practice Address - Street 1:1127 E OWEN K GARRIOTT RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-6151
Practice Address - Country:US
Practice Address - Phone:580-234-7320
Practice Address - Fax:580-234-5520
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK22775207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
800522073Medicare ID - Type Unspecified