Individual
DR. PETER THOMAS BEAUDETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7110 WYOMING BLVD NE, ALBUQUERQUE, NM 87109-4867
(505) 346-0500
Mailing address
7110 WYOMING BLVD NE, ALBUQUERQUE, NM 87109-4867
(505) 346-0500
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
77129
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00002030
—
NM
01
—
11399
PRESBYTERIAN HEALTH PLAN
NM
Enumeration date
02/20/2006
Last updated
12/14/2009
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