Individual
DR. BENJAMIN LEE WAGENMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 CENTRAL AVE SE, PHS- LAB - S1 LEVEL, ALBUQUERQUE, NM 87106-4930
(505) 841-1330
Mailing address
1100 CENTRAL AVE SE, PHS- LAB - S1 LEVEL, ALBUQUERQUE, NM 87106-4930
(505) 841-1330
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
MD2011-0037
NM
Other
Enumeration date
12/20/2007
Last updated
11/26/2012
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