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General NPI Number Information
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NPI Number | 1235865759
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Entity Type | Individual
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Provider Name | SAI SUBRAMANYAM KOMMINENI MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 700 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5004
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Country | US
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Telephone | 606-595-8580
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Fax |
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Provider Business Mailing Address
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Address Line | 75 READI MIX SPUR ROAD, APT 13
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City | HARLAN
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State | KY
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Zip | 40831
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 45527
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License Number State | OK
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