Basic Information
| Provider Information | |||||||||
| NPI: | 1598813016 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KALYANARAMAN | ||||||||
| FirstName: | VENKATARAMAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2525 STEEPLECHASE RD | ||||||||
| Address2: | |||||||||
| City: | EDMOND | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730345875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052855793 | ||||||||
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| Practice Location | |||||||||
| Address1: | 920 STANTON L YOUNG BLVD # 1345 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052715896 | ||||||||
| FaxNumber: | 4052717522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 20440 | OK | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.