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Individual

THOMAS JOHN BETJEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
MSC 09 5040, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-6607
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A150085
CA
207Q00000X
Family Medicine Physician
Primary
MD2017-0422
NM

Other

Enumeration date
04/14/2014
Last updated
10/13/2017
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