Organization
CALYX DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATHERINE TCHANQUE-FOSSUO MD, MS, FAAD (DERMATOLOGIST/MOHS SURGEON)
(240) 367-2980
Entity
Organization
Contact information
Practice address
612 ENCINO PL NE, ALBUQUERQUE, NM 87102-2602
(240) 367-2980
Mailing address
5863 MAFRAQ AVE NW, ALBUQUERQUE, NM 87114-6071
(240) 367-2980
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Enumeration date
06/04/2024
Last updated
07/25/2024
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