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Organization

POJOAQUE FAMILY PRACTICE, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES JAMES MAESTAS M.D. (PRESIDENT/PHYSICIAN)
(505) 455-2842
Entity
Organization

Contact information

Practice address
5 PETROGLYPH CIR, STE. B, SANTA FE, NM 87506-1001
(505) 455-2842
(505) 455-2941
Mailing address
11 W GUTIERREZ UNIT 3810, SANTA FE, NM 87506-0228
(505) 455-2842
(505) 455-2941

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
000
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07930
NM
Enumeration date
09/20/2006
Last updated
04/16/2010
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