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Individual

MARIA P GOBENCION

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
516 E. NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1650
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1650

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
205504
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000F8276
NM
05
551243
AZ
Enumeration date
07/05/2006
Last updated
04/14/2008
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