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Organization
MARIE ROUSSEAU MD PC
Active
Organization
MARIE ROUSSEAU MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE ROUSSEAU MD (MEDICAL DOCTOR)
(505) 327-5336
Entity
Organization
Contact information
Practice address
804 E NAVAJO ST, FARMINGTON, NM 87401-9119
(505) 327-5336
(505) 326-9120
Mailing address
804 E NAVAJO ST, FARMINGTON, NM 87401-9119
(505) 327-5336
(505) 326-9120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
81-303
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09621
—
NM
Enumeration date
08/26/2010
Last updated
09/28/2010
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