Individual
DR. CHARLES EDWARD MAHAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD, PHC, RPH
Contact information
Practice address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 727-8877
(505) 727-9269
Mailing address
13215 RUSSIAN SAGE CT NE, ALBUQUERQUE, NM 87111-8270
(505) 821-0383
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
RP6003, PC107
NM
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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