Individual
MATTHEW S FOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
3129 CASA BONITA DR NE, ALBUQUERQUE, NM 87111-5607
(505) 239-7679
Mailing address
3129 CASA BONITA DR NE, ALBUQUERQUE, NM 87111-5607
(505) 239-7679
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61223
NM
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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