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Individual

NILS ROSENBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
PMG KASEMAN BEHAVIORAL MEDICINE, 1325 WYOMING NE, ALBUQUERQUE, NM 87112
(505) 291-5300
(505) 291-5303
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD2007-0140
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
26931036
NM
Enumeration date
02/06/2007
Last updated
01/26/2011
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