Provider Demographics
NPI:1417926387
Name:GREWAL, HARLEEN (MD)
Entity Type:Individual
Prefix:
First Name:HARLEEN
Middle Name:
Last Name:GREWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W MORROW RD
Mailing Address - Street 2:100
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-6549
Mailing Address - Country:US
Mailing Address - Phone:918-245-2309
Mailing Address - Fax:918-293-3181
Practice Address - Street 1:2440 E 81ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4200
Practice Address - Country:US
Practice Address - Phone:918-477-5190
Practice Address - Fax:918-477-5199
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13201207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD34725Medicare UPIN