Provider Demographics
NPI:1356195879
Name:KOSHEVAROVA, VICTORIA ANDREEVNA (MD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANDREEVNA
Last Name:KOSHEVAROVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIKTORIYA
Other - Middle Name:ANDREEVNA
Other - Last Name:KOSHEVAROVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1000 N LEE AVE STE 1980
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1036
Mailing Address - Country:US
Mailing Address - Phone:405-272-8437
Mailing Address - Fax:405-231-3007
Practice Address - Street 1:1000 N LEE AVE STE 1980
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1036
Practice Address - Country:US
Practice Address - Phone:405-272-8437
Practice Address - Fax:405-231-3007
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program