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RAJU, SUMA NANDAKUMAR       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 1200 N PHILIPS AVE
14400
OKLAHOMA CITY OK 73104

Address last updated on 8/17/2011
Phone #: (405) 271-5884
Fax #:
County: OKLAHOMA
License: 24557
Dated: 10/19/2006
Expires: 10/1/2012
License Type: Medical Doctor
Specialty: Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Tx Tech Univ Hlth Sci Ctr Sch Of Med, Lubbock Tx 79430
Graduated: 5 / 2004
CME Year: 2012
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PEDIATRICS
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: OU Health Medical Center
Oklahoma City, OK
Locations: Hours: Languages:
1200 N PHILIPS AVE
14400
OKLAHOMA CITY OK 73104

Phone #: (405) 271-5884
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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