Healthcare Provider Details

I. General information

NPI: 1598720013
Provider Name (Legal Business Name): AMIT P SAHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 W MEMORIAL RD STE 909
OKLAHOMA CITY OK
73120-9350
US

IV. Provider business mailing address

4200 W MEMORIAL RD STE 909
OKLAHOMA CITY OK
73120-9350
US

V. Phone/Fax

Practice location:
  • Phone: 405-749-4201
  • Fax: 405-749-4208
Mailing address:
  • Phone: 405-749-4201
  • Fax: 405-749-4208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number22328
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: