Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 29232 | OK |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 29232 | OK |
NPI | 1356602080 |
---|---|
Provider Name | Marta Maxted |
First Address | Oklahoma City, OK 73104-5036 |
Second Address | Oklahoma City, OK 73104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2012 |
Last Update Date | 30/05/2018 |