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Individual
DR. MARA RENEE ARCHAMBAULT
Active
Individual
DR. MARA RENEE ARCHAMBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2008-0205
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263282YKR1
MEDICARE PTAN
NM
05
—
51659328
—
NM
Enumeration date
02/06/2007
Last updated
12/04/2025
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