DR. SHYAM SUNDER POLUDASU (NPI# 1811171705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811171705 |
| Entity Type | Individual |
| Full Name | DR. SHYAM SUNDER POLUDASU |
| Credential | M.D |
| Practice Address |
1301 W 6th Ave Ste 207 Stillwater OK 74074-4375 |
| Mailing Address |
Po Box 720006 Norman OK 73070-4006 |
| Practice Telephone | 4055333010 |
| Mailing Telephone | 4055336099 |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2015-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
28749 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
1301 W 6TH AVE STE 207 |
| City | STILLWATER |
| State | OK |
| Zip Code | 74074-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972596641 | Alison Faith Dancer | Psychiatry & Neurology | 1301 W 6th Ave, Suite 210, Stillwater, OK 74074-4381 | 2005-08-26 |
| 1932655966 | Caitlin Kronenwetter | Physician Assistant | 1301 W 6th Ave, Ste 207, Stillwater, OK 74074-4375 | 2016-08-30 |
| 1619337433 | Erin Hutchison | Physician Assistant | 1301 W 6th Ave, Ste 207, Stillwater, OK 74074-4375 | 2016-03-07 |
| 1669770145 | Jawad Trad | Internal Medicine | 1301 W 6th Ave, Suite 208, Stillwater, OK 74074-4375 | 2011-03-07 |
| 1235212630 | Jack T Dancer I | Surgery | 1301 W 6th Ave, Suite 105, Stillwater, OK 74074-4375 | 2006-10-23 |
| 1699866616 | Stillwater Heart Center Inc | Specialist | 1301 W 6th Ave, Suite 110, Stillwater, OK 74074-4375 | 2006-09-27 |
| 1679588552 | Stillwater Medical Center Authority | Psychiatry & Neurology | 1301 W 6th Ave, Suite 108, Stillwater, OK 74074-4375 | 2006-07-30 |
| 1194708545 | James A. Waltermire | Radiology | 1301 W 6th Ave, Suite 202, Stillwater, OK 74074-4375 | 2005-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366090680 | Jason K. White, Ph.d., LLC | Psychologist | 807 S. Pine St., Stillwater, OK 74074 | 2019-08-29 |
| 1366095861 | Kelsey Lyn Bigheart | Peer Specialist | 5421 S Deer Trail, Stillwater, OK 74074 | 2019-07-23 |
| 1881256691 | Shelly Lynn Green | Nurse Practitioner | 1321 W. 7th Street, Stillwater, OK 74074 | 2019-07-01 |
| 1811426273 | Judy Catlett | Case Manager/Care Coordinator | 800 E. 6th Str, Stillwater, OK 74074 | 2017-06-08 |
| 1518322296 | Abi Physical Therapy Services | Physical Therapist | 810 S. Walnut Street, Stillwater, OK 74074 | 2015-12-22 |
| 1366833451 | Connecting The Pieces | Case Management | 812 S Walnut, Stillwater, OK 74074 | 2015-02-10 |
| 1790122414 | Airie Flanagan | Doula | 2601 Gregory Ln, Stillwater, OK 74074 | 2013-06-04 |
| 1760720668 | Stillwater Histology LLC | Internal Medicine | 1301 W. 6th St, Suite 106, Stillwater, OK 74074 | 2013-01-28 |
| 1144570565 | Nikkie Jo Dunnigan | Counselor | 2322 W 7th, Stillwater, OK 74074 | 2012-09-13 |
| 1487889952 | Lynn B. Roberts | General Practice | 1321 W 7th St, Stillwater Community Health, Stillwater, OK 74074 | 2009-05-27 |
| Find all providers in zip 74074 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215346507 | Thomas Russell II | Internal Medicine | 12315 Otchipwe Ave N, Stillwater, MN 55082-9547 | 2014-08-12 |
| 1932147113 | Melchor Ng Lim | Internal Medicine | 1509 W 8th Ave, Stillwater, OK 74074-4321 | 2006-06-02 |
| 1417139924 | James Bryan Harris | Internal Medicine | 1323 W 6th Ave Ste 201, Stillwater, OK 74074-4306 | 2007-11-27 |
| 1679558977 | Lyle James Swenson | Internal Medicine | 927 Churchill St W, Stillwater, MN 55082 | 2005-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730790148 | Epic Heart Health | Internal Medicine | 1211 N Shartel Ave Ste 1005, Oklahoma City, OK 73103-2433 | 2020-08-11 |
| 1801355813 | Tulsa Cardiovascular Center of Excellence, L.l.c | Internal Medicine | 11912 S Norwood Ave Ste 105, Tulsa, OK 74137-5509 | 2019-03-19 |
| 1316469109 | Razan Ali Mohamed Elsayed | Internal Medicine | 800 Stanton L Young Blvd # 5481, Oklahoma City, OK 73104-5018 | 2017-07-12 |
| 1184043556 | Heart & Vascular Specialist of Oklahoma Pllc | Internal Medicine | 15601 Kestral Park Ct, Edmond, OK 73013-9505 | 2014-04-14 |
| 1316283724 | Jean Ann Pitts | Internal Medicine | 11177 Ns 367 Rd, Okemah, OK 74859-4437 | 2012-12-13 |
| 1356621353 | Taraka Vijaya Rama Raju Gadiraju | Internal Medicine | 6151 S Yale Ave Ste 1-304, Tulsa, OK 74136-1907 | 2011-08-22 |
| 1760776694 | Biyebelemo A Ekpete | Internal Medicine | 2115 Duncan Regional Loop Ste 200, Duncan, OK 73533-1577 | 2011-06-08 |
| 1174750749 | Matthew Joseph Comstock | Internal Medicine | 11912 S Norwood Ave Ste 110, Tulsa, OK 74137-5509 | 2009-06-22 |
| 1841441151 | Mohamad A. Mahayni, M.d., Inc. | Internal Medicine | 3502 W Okmulgee St, Muskogee, OK 74401-5073 | 2008-10-06 |
| 1225201718 | Christian Cardiovascular Institute PC | Internal Medicine | 3300 Nw 56th Street, Suite 200, Oklahoma City, OK 73112-4401 | 2008-04-07 |
| Find all providers with the same taxonomy | ||||
| City | STILLWATER |
| Zip Code | 74074 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.