Individual
MRS. MEGAN ELIZABETH MOLLECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 291-2402
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2016-0571
NM
Other
Enumeration date
05/10/2013
Last updated
09/08/2016
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