Individual
MAHMOOD REZA VAEZZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4705 MONTGOMERY BLVD NE, SUITE 301, ALBUQUERQUE, NM 87109-1226
(505) 727-4500
(505) 727-4505
Mailing address
4705 MONTGOMERY BLVD NE, SUITE 301, ALBUQUERQUE, NM 87109-1226
(505) 727-4500
(505) 727-4505
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD2008-0583
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95735526
—
NM
Enumeration date
08/26/2008
Last updated
11/25/2015
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