Provider Demographics
NPI:1982778643
Name:OKSHTEYN, MARA (MD)
Entity type:Individual
Prefix:DR
First Name:MARA
Middle Name:
Last Name:OKSHTEYN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARA
Other - Middle Name:
Other - Last Name:FREMDERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 36108
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85740-6108
Mailing Address - Country:US
Mailing Address - Phone:520-812-7180
Mailing Address - Fax:877-571-5978
Practice Address - Street 1:200 W MAGEE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85704-6492
Practice Address - Country:US
Practice Address - Phone:520-812-7180
Practice Address - Fax:855-523-4050
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34041207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
G74892Medicare UPIN