Individual
DR. IRENE JUNE MOODY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3410 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1148
(505) 265-7817
(505) 266-1543
Mailing address
3410 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1148
(505) 265-7817
(505) 266-1543
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
83262
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30742
—
NM
Enumeration date
07/05/2005
Last updated
07/08/2007
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