Individual
DR. MUSTAPHA KAMEL ABOUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1302 E CALLE DE MERCED, ESPANOLA, NM 87532
(505) 753-9292
(505) 753-1866
Mailing address
PO BOX 2219, ESPANOLA, NM 87532-2219
(505) 753-9292
(505) 753-1866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M020550567
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202005111
PRESBYTERIAN
NM
01
—
90382
LOVELACE COMMERCIAL
NM
05
—
98800825
—
NM
01
—
NM009X52
BCBS
NM
01
—
QMYPR0070730
MOLINA
NM
01
—
SX159
LOVELACE SALUD
NM
Enumeration date
09/26/2006
Last updated
04/13/2008
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