Individual
ELAINE MARY MADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 2ND AVE SW, MIAMI, OK 74354-6830
(918) 542-6611
(405) 553-5633
Mailing address
200 2ND AVE SW, MIAMI, OK 74354-6830
(918) 542-6611
(405) 553-5633
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16786
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100193100A
—
OK
05
—
100699440M
—
OK
05
—
209879907
—
MO
05
—
500156005
—
MO
Enumeration date
02/22/2006
Last updated
04/22/2008
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