Healthcare Provider Details

I. General information

NPI: 1689169211
Provider Name (Legal Business Name): RAMIT RELAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 NE 13TH ST # 3G3210
OKLAHOMA CITY OK
73104-5008
US

IV. Provider business mailing address

1200 EVERETT DR
OKLAHOMA CITY OK
73104-5047
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-5125
  • Fax: 405-271-3462
Mailing address:
  • Phone: 405-271-5125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License NumberMT228319
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number34605
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: