Provider Demographics
NPI:1689297244
Name:HARSHA, STEVEN MARK (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MARK
Last Name:HARSHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 STANTON L YOUNG BLVD # 6300
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5018
Mailing Address - Country:US
Mailing Address - Phone:405-271-5963
Mailing Address - Fax:
Practice Address - Street 1:1000 NE 13TH ST STE 1G
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5040
Practice Address - Country:US
Practice Address - Phone:405-271-3445
Practice Address - Fax:405-271-3401
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1689297244390200000X
390200000X
OK36054390200000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty