Provider Demographics
NPI:1770692683
Name:KUMAR, NAVEEN NANDIGAMA (MD)
Entity type:Individual
Prefix:DR
First Name:NAVEEN
Middle Name:NANDIGAMA
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10159 E.11 ST
Mailing Address - Street 2:STE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74128-3046
Mailing Address - Country:US
Mailing Address - Phone:918-835-5033
Mailing Address - Fax:918-835-5760
Practice Address - Street 1:10159 E.11 ST
Practice Address - Street 2:STE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-3046
Practice Address - Country:US
Practice Address - Phone:918-835-5033
Practice Address - Fax:918-835-5760
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK200372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry