Individual
MARY E MOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
80 B VETERANS BLVD, ACOMA, NM 87034
(505) 552-5385
(505) 552-5828
Mailing address
P.O. BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5385
(505) 552-5828
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19675
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
08/29/2006
Last updated
12/23/2024
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