Provider Demographics
NPI:1952399024
Name:CHOPRA, SANDEEP (MD)
Entity Type:Individual
Prefix:
First Name:SANDEEP
Middle Name:
Last Name:CHOPRA
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 1:4120 N CLASSEN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-2422
Mailing Address - Country:US
Mailing Address - Phone:405-236-3736
Mailing Address - Fax:405-236-2137
Practice Address - Street 1:4120 N CLASSEN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2422
Practice Address - Country:US
Practice Address - Phone:405-236-3736
Practice Address - Fax:405-236-3737
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22631207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKH35304Medicare UPIN
OKOK700716Medicare PIN