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General NPI Number Information
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NPI Number | 1841582681
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Entity Type | Individual
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Provider Name | SHINOBU ITAGAKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 825 NE 10TH ST STE 4G
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5417
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Country | US
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Telephone | 405-271-5789
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Fax | 405-271-1643
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Provider Business Mailing Address
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Address Line | 515 CENTRAL PARK DR STE 5009
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City | OKLAHOMA CITY
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State | OK
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Zip | 73105-1724
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Country | US
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Telephone | 405-764-8066
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 390200000X
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 43760
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License Number State | OK
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