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Individual

MAXIMUS L'AMOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2400 UNSER BLVD SE STE 19400, RIO RANCHO, NM 87124-4740
(505) 253-6100
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2014-0098
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
16008812
NM
Enumeration date
05/19/2008
Last updated
02/25/2022
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