Individual
MONTHIDA FANGTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
DOIM RHEUMATOLOGY, 1 UNIVERSITY OF NEW MEXICO MSC 10-5550, ALBUQUERQUE, NM 87131-0001
(505) 272-4761
(505) 272-3624
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD2015-0730
NM
207RR0500X
Rheumatology Physician
MD451462
PA
Other
Enumeration date
09/14/2007
Last updated
03/22/2017
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