Individual
DR. CHARLES JAMES MAESTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 PETROGYPH CIRCLE, STE. B, POJOAQUE, NM 87506-0810
(505) 455-2842
(505) 455-2941
Mailing address
5 PETROGLYPH CIR STE B, SANTA FE, NM 87506-1001
(505) 455-2842
(505) 455-2941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
88-216
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07930
—
NM
Enumeration date
03/08/2007
Last updated
08/26/2020
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