Provider Demographics
NPI:1841271079
Name:MACARAEG, EMMANUEL NAJERA (MD)
Entity type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:NAJERA
Last Name:MACARAEG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 S GARNETT RD
Mailing Address - Street 2:SUITE 919
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5229
Mailing Address - Country:US
Mailing Address - Phone:918-728-6194
Mailing Address - Fax:918-664-2521
Practice Address - Street 1:1 S BRYANT AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6309
Practice Address - Country:US
Practice Address - Phone:918-728-6194
Practice Address - Fax:918-664-2521
Is Sole Proprietor?:No
Enumeration Date:2005-11-05
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13689207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00296402OtherRAILROAD MEDICARE
E07892Medicare UPIN