Individual
DR. ROBERT BIBEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DOM
Contact information
Practice address
7820 PAN AMERICAN FWY, NE, STE 3, ALBUQUERQUE, NM 87109-4655
(505) 828-9642
(505) 828-9191
Mailing address
7717 ROBERTS ST. NE, ALBUQUERQUE, NM 87109-5250
(505) 681-5603
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
DOM1275
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15201639
CAQH
—
Enumeration date
07/21/2021
Last updated
12/08/2021
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