Individual
MAHMOOD REZA ZAMANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 291-2200
(505) 291-2233
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
98-424
NM
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
98-424
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z5306
—
NM
Enumeration date
06/30/2005
Last updated
11/15/2016
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