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Individual

MATEO G BOSQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2929 COORS BLVD NW, ALBUQUERQUE, NM 87120
(505) 839-2300
(505) 839-2303
Mailing address
PO BOX 27829, ALBUQUERQUE, NM 87125
(505) 232-1920
(505) 727-9276

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
74123
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
91926262
NM
Enumeration date
10/12/2006
Last updated
12/01/2009
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