Healthcare Provider Details

I. General information

NPI: 1477847374
Provider Name (Legal Business Name): BHALAAJEE MEENAKSHI-SUNDARAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE # 7D
OKLAHOMA CITY OK
73104
US

IV. Provider business mailing address

920 STANTON L YOUNG BLVD # WP2140
OKLAHOMA CITY OK
73104-5036
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-3800
  • Fax: 405-271-3801
Mailing address:
  • Phone: 405-271-6900
  • Fax: 405-271-3118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number28575
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number28575
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: