Provider Demographics
NPI:1215999479
Name:MAREBURGER, STEVEN ROSS (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ROSS
Last Name:MAREBURGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:580-233-2300
Mailing Address - Fax:580-548-1489
Practice Address - Street 1:707 S. MONROE STREET
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701
Practice Address - Country:US
Practice Address - Phone:580-548-1367
Practice Address - Fax:580-548-1537
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK19224207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100097070BMedicaid
OK100097070CMedicaid
OKF99771Medicare UPIN
OK100097070BMedicaid
OKP00187809Medicare PIN