Individual
TAMMY RENEE MASCHINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2800 N KELLY AVE, STE 200, EDMOND, OK 73003-3008
(405) 726-8000
(405) 726-8101
Mailing address
2800 N KELLY AVE, STE 200, EDMOND, OK 73003-3008
(405) 726-8000
(405) 726-8101
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
21370
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100125730B
—
OK
Enumeration date
10/27/2005
Last updated
04/28/2014
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