PATHAK, SUJAN - Licensee Information - Oklahoma Medical Board

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

PATHAK, SUJAN

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:	KIDNEY SPECIALIST OF CENTRAL OKLAHOMA 3366 NW EXPRESSWAY SUITE 550 OKLAHOMA CITY OK 73112-4489 Address last updated on 2/7/2023
Phone #:	(405) 942-5442
Fax #:	(405) 942-6448
County:	OKLAHOMA
License:	32023
Dated:	3/3/2016
Expires:	3/1/2025
License Type:	Medical Doctor
Specialty:	Nephrology Internal Medicine

Status:	Active
Status Class:	Fully Licensed
Restricted to:
Registered to Dispense:	NO
Medical School:	Tribhuvan Univ, Inst Of Med, Kathmandu, Nepal
Graduated:	10 / 2001
CME Year:	2025

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 INTERNAL MEDICINE AMERICAN BOARD OF INTERNAL MEDICINE - Nephrology
New Patients:	Yes
Medicaid:	Yes
Medicare:	Yes

HMO/PPO:	Aetna Elect Choice Aetna HMO Aetna Managed Choice Aetna PPO Blue Cross Blue Shield-Blue Preferred Blue Cross Blue Shield-Blue Traditional Blue Cross Blue Shield-Plan 65 Select BlueChoice PPO BlueLincs HMO Champ VA CIGNA HMO CIGNA PPO CommunityCare HMO, Inc CommunityCare Senior HMO Coventry Health Care National Network Global Health HMO Great West Healthcare HealthChoice Humana ChoiceCare Humana Medicare Advantage PPO Humana Tricare/PGBA Medicare Blue Railroad Medicare Secure Horizons HMO SoonerCare HMO SoonerCare PPO Tricare for Life Tricare Standard United Healthcare Choice United Healthcare EPO United Healthcare HMO United Healthcare Options PPO United Healthcare POS
Hospital Privileges:	INTEGRIS Baptist Medical Center Oklahoma City, OK INTEGRIS Baptist Portland Ave (fmly Deaconess Hospital) Oklahoma City, OK INTEGRIS Canadian Valley Regional Hospital Yukon, OK INTEGRIS Edmond Edmond, OK INTEGRIS Southwest Medical Center Oklahoma City, OK Select Specialty Hospital-OKC Oklahoma City, OK

Locations:	Hours:	Languages:
KIDNEY SPECIALIST OF CENTRAL OKLAHOMA 3366 NW EXPRESSWAY SUITE 550 OKLAHOMA CITY OK 73112-4489 Phone #: (405) 942-5442 Fax #: (405) 942-6448	Mon: 8:30AM - 5:00PM Tue: 8:30AM - 5:00PM Wed: 8:30AM - 5:00PM Thu: 8:30AM - 5:00PM Fri: 8:30AM - 5:00PM Sat: Sun:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisees(s):
PAUL LAWRENCE HART	PA	2007

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