Individual
PAUL JOSEPH GREENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6609 BEAU CHENE NE, ALBUQUERQUE, NM 87111-6500
(505) 299-2193
Mailing address
6609 BEAU CHENE NE, ALBUQUERQUE, NM 87111-6500
(505) 299-2193
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
72149
NM
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
72149
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00011098
—
NM
05
—
207R00000X
—
NM
Enumeration date
01/05/2007
Last updated
05/13/2008
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