Healthcare Provider Details

I. General information

NPI: 1285114074
Provider Name (Legal Business Name): GUILHERME CARDINALI BARREIRO MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 NE 10TH ST STE 1G
OKLAHOMA CITY OK
73104-5417
US

IV. Provider business mailing address

800 STANTON L YOUNG BLVD STE 8300
OKLAHOMA CITY OK
73104-5018
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4864
  • Fax: 405-271-2737
Mailing address:
  • Phone: 405-271-2220
  • Fax: 405-271-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35757
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number35757
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number35757
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number35757
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: