Healthcare Provider Details

I. General information

NPI: 1588042287
Provider Name (Legal Business Name): NITIN SAWHENY, M.D., P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 05/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2074 BELLA SERA DR
EDMOND OK
73034-2525
US

IV. Provider business mailing address

2074 BELLA SERA DR
EDMOND OK
73034-2525
US

V. Phone/Fax

Practice location:
  • Phone: 405-601-6181
  • Fax: 405-601-7012
Mailing address:
  • Phone: 405-601-6181
  • Fax: 405-601-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number25809
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25809
License Number StateOK

VIII. Authorized Official

Name: NITIN SAWHENY
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 405-601-6181