Individual
MARK EDWARD UNVERZAGT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 COAL AVE SW, ALBUQUERQUE, NM 87102-3743
(505) 246-1670
Mailing address
PO BOX 313, ALBUQUERQUE, NM 87103-0313
(505) 245-1670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
91-336
NM
Other
Enumeration date
11/17/2005
Last updated
06/06/2011
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