Individual
DR. ATHANASIOS KOSTANDINOS MANOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1540 JUAN TABO BLVD NE STE A, ALBUQUERQUE, NM 87112-4460
(505) 529-8511
Mailing address
1540 JUAN TABO BLVD NE STE A, ALBUQUERQUE, NM 87112-4460
(505) 529-8511
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
MD20150915
NM
2083P0901X
Public Health & General Preventive Medicine Physician
MD2015-0915
NM
2083X0100X
Occupational Medicine Physician
MD2015-0915
NM
208VP0014X
Interventional Pain Medicine Physician
Primary
MD2015-0915
NM
Other
Enumeration date
04/02/2014
Last updated
03/20/2026
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