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Individual

VILLA AULEEN DEL CARMEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
801 W MAPLE ST, FARMINGTON, NM 87401-5630
(505) 609-6463
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0116015347
VA
207R00000X
Internal Medicine Physician
Primary
MD2006-0490
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15064401
FARMINGTON AHCCCS
NM
01
22103007
HOBBS AHCCCS
NM
05
22103007
NM
01
P00382871
RAILROAD MEDICARE
NM
Enumeration date
08/08/2006
Last updated
07/25/2008
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