Individual
DOROTHY F GAULT-MCNEMEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5290 MCNUTT ROAD, SANTA TERESA, NM 88008-1590
(505) 589-1144
(505) 589-2008
Mailing address
PO BOX 1590, SANTA TERESA, NM 88008-1590
(505) 589-1144
(505) 589-2008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NMMD81200
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4536409
AETNA
TX
01
—
NM001020
BLUE CROSS BLUE SHIELD
NM
Enumeration date
05/17/2006
Last updated
04/04/2008
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