Provider Demographics
NPI:1861448367
Name:ARAMBULA, MARTHA B (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:B
Last Name:ARAMBULA
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 196
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73101-0196
Mailing Address - Country:US
Mailing Address - Phone:405-577-6700
Mailing Address - Fax:405-265-0973
Practice Address - Street 1:1804 COMMONS CIR
Practice Address - Street 2:SUITE B
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-9524
Practice Address - Country:US
Practice Address - Phone:405-577-6700
Practice Address - Fax:405-265-0973
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18982208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100822630AMedicaid