Individual
MARIAMA AMINA MASSAQUOI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613
(719) 396-4896
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-17819
HI
Other
Enumeration date
07/11/2013
Last updated
02/06/2019
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