| Monogram Health Professional Services Of Oklahoma Pllc | |
|
5410 Maryland Way Ste 301 Brentwood TN 37027-5339 | |
| (615) 673-4455 | |
| Not Available |
| Full Name | Monogram Health Professional Services Of Oklahoma Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5410 Maryland Way Ste 301, Brentwood, Tennessee |
| Authorized Official Name and Position | Shaminder Gupta (CMO) |
| Authorized Official Contact | 5043320370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monogram Health Professional Services Of Oklahoma Pllc 5410 Maryland Way Ste 301 Brentwood TN 37027-5339 Ph: (615) 673-4455 | Monogram Health Professional Services Of Oklahoma Pllc 5410 Maryland Way Ste 301 Brentwood TN 37027-5339 Ph: (615) 673-4455 |
| NPI Number | 1982310686 |
|---|---|
| Provider Enumeration Date | 01/25/2023 |
| Last Update Date | 01/25/2023 |
| Medicare PECOS PAC ID | 3577938430 |
|---|---|
| Medicare Enrollment ID | O20230405003052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982310686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Shaminder Gupta |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730183401 PECOS PAC ID: 1658322300 Enrollment ID: I20230407001720 |
| Provider Name | Rashmi Bisla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265758635 PECOS PAC ID: 0143531871 Enrollment ID: I20231206003388 |
| Provider Name | Olivia S Woita |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922305143 PECOS PAC ID: 6709054406 Enrollment ID: I20240611002496 |
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