Individual
BENJAMIN QUIAMBAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3750 W MAIN ST STE AA, NORMAN, OK 73072-4645
(405) 790-0500
(405) 790-0501
Mailing address
PO BOX 6708, MOORE, OK 73153-0708
(405) 790-0500
(405) 790-0501
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
24708
OK
2084P0800X
Psychiatry Physician
C149557
CA
2084P0804X
Child & Adolescent Psychiatry Physician
24708
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200238960A
—
OK
05
—
200271930A
—
OK
Enumeration date
05/08/2007
Last updated
09/28/2024
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