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Oklahoma Board of Medical Licensure and Supervision

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

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BANSAL, SHIVENDRA KUMAR       
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: 3214 KETHLEY ROAD
SHAWNEE OK 74804

Address last updated on 6/17/2024
Phone #: (405) 273-5801
Fax #: (405) 878-3794
County: POTTAWATOMIE
License: 32293
Dated: 7/1/2018
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Family Medicine
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: NO
Medical School: Univ of Sint Eustatius, Sint Eustatius, Netherland Antilles
Graduated: 2 / 2016
CME Year: 2027
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 FAMILY MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: SSM Health St. Anthony Shawnee Hospital (fmly Unity Health Ctr)
Shawnee, OK
Locations: Hours: Languages:
3214 KETHLEY ROAD
SHAWNEE OK 74804

Phone #: (405) 273-5801
Fax #: (405) 878-3794
Mon: 8:00AM - 5:00PM
Tue: 8:00AM - 5:00PM
Wed: 8:00AM - 5:00PM
Thu: 8:00AM - 5:00PM
Fri: 8:00AM - 5:00PM
Sat:
Sun:

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