Provider Demographics
NPI:1598720013
Name:SAHA, AMIT P (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:P
Last Name:SAHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4200 W MEMORIAL RD
Mailing Address - Street 2:STE 909
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9350
Mailing Address - Country:US
Mailing Address - Phone:405-749-4201
Mailing Address - Fax:405-749-4208
Practice Address - Street 1:4200 W MEMORIAL RD
Practice Address - Street 2:STE 909
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9350
Practice Address - Country:US
Practice Address - Phone:405-749-4201
Practice Address - Fax:405-749-4208
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2012-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK22328208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100004790BMedicaid
OKH41946Medicare UPIN
OK100004790BMedicaid
OK100522039Medicare ID - Type UnspecifiedGROUP NUMBER