Individual
MARS SURBANO MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7109 W HEFNER RD, SUITE D, OKLAHOMA CITY, OK 73162-4534
(405) 722-5500
(405) 720-4404
Mailing address
7109 W HEFNER RD, SUITE D, OKLAHOMA CITY, OK 73162-4535
(405) 722-5500
(405) 720-4404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13951
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100253420B
—
OK
01
—
400522462
MEDICARE GROUP NUMBER
OK
Enumeration date
08/07/2006
Last updated
06/12/2008
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