Individual
DIANA KOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87108-1434
(505) 265-5976
Mailing address
719 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87108-1434
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
80-192
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00007187
—
NM
Enumeration date
10/05/2006
Last updated
07/08/2007
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