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Individual

DR. TERRY LEONID HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
201 CEDAR ST SE STE 6600, ALBUQUERQUE, NM 87106
(505) 724-4300
(505) 724-4384
Mailing address
1540 JUAN TABO BLVD NE, STE A, ALBUQUERQUE, NM 87112-4460
(505) 800-7246
(505) 207-5221

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD2015-0101
NM
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
85936529
NM
Enumeration date
04/26/2010
Last updated
01/06/2022
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