Provider Demographics
NPI:1558448365
Name:NEVREKAR, LILA (MD)
Entity Type:Individual
Prefix:
First Name:LILA
Middle Name:
Last Name:NEVREKAR
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 1:15951 LITTLE AXE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026-9088
Mailing Address - Country:US
Mailing Address - Phone:405-447-0300
Mailing Address - Fax:405-701-7914
Practice Address - Street 1:6 CASTLE CREEK PLACE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-2332
Practice Address - Country:US
Practice Address - Phone:405-275-4987
Practice Address - Fax:405-273-4879
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK10357207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C95290Medicare UPIN