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NPI Code Detail

MEDICARE: SAINTS MEDICAL GROUP, LLC

MEDICARE: SAINTS MEDICAL GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist
2207LP2900XPain Medicine (Anesthesiology) Physician
3207N00000XDermatology Physician
4207R00000XInternal Medicine Physician
5207RC0000XCardiovascular Disease Physician
6207RN0300XNephrology Physician
7207RP1001XPulmonary Disease Physician
8207U00000XNuclear Medicine Physician14498OK
9207V00000XObstetrics & Gynecology Physician
10207X00000XOrthopaedic Surgery Physician
11208000000XPediatrics Physician
122084N0400XNeurology Physician
132086S0129XVascular Surgery Physician
14208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
15207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437195922
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAINTS MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : 777 NW 63RD ST STE 452
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-7601
Country : US
Telephone Number : 405-231-3857
Fax Number : 405-272-7977
Provider Business Practice Location Address
First Line : 777 NW 63RD ST STE 452
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-7601
Country : US
Telephone Number : 405-231-3857
Fax Number : 405-272-7977
Authorized Official
Title or Position : VP - FINANCE
Name : SHASTA MANUEL
Credential :
Telephone Number : 405-272-7282
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/01/2024

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