Individual
TAMARA GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4901 LANG AVE NE, ALBUQUERQUE, NM 87109-4495
(505) 842-8171
Mailing address
4901 LANG AVE NE, ALBUQUERQUE, NM 87109-4495
(505) 842-8171
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2006-0823
NM
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD2006-0823
NM
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
MD2006-0823
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22705325
—
NM
Enumeration date
02/05/2007
Last updated
09/18/2019
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