| Kumar B Ennamuri MD PC | |
|
1125 N Porter Ave Ste 300 Norman OK 73071-6443 | |
| (405) 364-0630 | |
| (405) 364-0760 |
| Full Name | Kumar B Ennamuri MD PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1125 N Porter Ave Ste 300, Norman, Oklahoma |
| Authorized Official Name and Position | Kumar B. Ennamuri (OWNER) |
| Authorized Official Contact | 4053640630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kumar B Ennamuri MD PC 1125 N Porter Ave Ste 300 Norman OK 73071-6443 Ph: (405) 364-0630 | Kumar B Ennamuri MD PC 1125 N Porter Ave Ste 300 Norman OK 73071-6443 Ph: (405) 364-0630 |
| NPI Number | 1467527044 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 09/11/2025 |
| Certification Date | 09/11/2025 |
| Medicare PECOS PAC ID | 8022062256 |
|---|---|
| Medicare Enrollment ID | O20050330001085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467527044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| Provider Name | Kumar Ennamuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396783056 PECOS PAC ID: 9436105616 Enrollment ID: I20050812000116 |
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