Individual
DR. KENNETH EGERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2050A 2ND ST SE, KIRTLAND AFB, NM 87117-5522
(505) 846-7695
Mailing address
2050A 2ND ST SE, KIRTLAND AFB, NM 87117-5522
(505) 846-7695
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101222073
VA
2083A0100X
Aerospace Medicine Physician
Primary
0101222073
VA
Other
Enumeration date
12/06/2005
Last updated
07/27/2009
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