Organization
MD FOR MEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON BETH GONZALES (CFO)
(505) 235-4228
Entity
Organization
Contact information
Practice address
8300 CARMEL AVE NE, SUITE 303, ALBUQUERQUE, NM 87122-3147
(505) 916-1768
Mailing address
8300 CARMEL AVE NE, SUITE 303, ALBUQUERQUE, NM 87122-3147
(505) 433-4665
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86635026
—
NM
Enumeration date
01/21/2014
Last updated
09/07/2014
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