Individual
MAHLI MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1770 TIERRA DE MESILLA, LAS CRUCES, NM 88005-3101
(575) 526-9189
(575) 652-4064
Mailing address
PO BOX 516, MESILLA, NM 88046-0516
(575) 526-9189
(575) 652-4064
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
PA2004-0055
NM
363A00000X
Physician Assistant
Primary
PA2004-0055
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84576863
—
NM
Enumeration date
07/30/2006
Last updated
11/23/2021
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