Provider Demographics
NPI:1942802236
Name:NANDA, ARJUN
Entity Type:Individual
Prefix:
First Name:ARJUN
Middle Name:
Last Name:NANDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 NW GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NICHOLS HILLS
Mailing Address - State:OK
Mailing Address - Zip Code:73116-4105
Mailing Address - Country:US
Mailing Address - Phone:405-924-3151
Mailing Address - Fax:
Practice Address - Street 1:2311 NW GRAND BLVD
Practice Address - Street 2:
Practice Address - City:NICHOLS HILLS
Practice Address - State:OK
Practice Address - Zip Code:73116-4105
Practice Address - Country:US
Practice Address - Phone:405-812-7406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program