Individual
KENNETH PAUL GOLDBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 MULBERRY NE, ALBUQUERQUE, NM 87106
(505) 243-9739
(505) 842-0650
Mailing address
303 MULBERRY NE, ALBUQUERQUE, NM 87106
(505) 243-9739
(505) 842-0650
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
71-145
NM
207W00000X
Ophthalmology Physician
Primary
NM145
NM
Other
Enumeration date
07/05/2005
Last updated
11/05/2008
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