Provider Demographics
NPI:1992741094
Name:WAINGANKAR, GAURI S (MD)
Entity type:Individual
Prefix:
First Name:GAURI
Middle Name:S
Last Name:WAINGANKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 268988
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8988
Mailing Address - Country:US
Mailing Address - Phone:405-605-6141
Mailing Address - Fax:405-605-6244
Practice Address - Street 1:1145 W I 240 SERVICE RD
Practice Address - Street 2:SUITE F100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2171
Practice Address - Country:US
Practice Address - Phone:405-605-6141
Practice Address - Fax:405-605-6244
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13381207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK347345700OtherDEPT OF LABOR
OK100021090AMedicaid
OK4472694OtherAETNA
OK100021090AMedicaid
OK4472694OtherAETNA
B13350Medicare UPIN