Bosque Internal Medicine LLC
Internal Medicine in Albuquerque, NM. Organization (NPI-2).
NPI number1982122479
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1982122479
- Entity type
- Organization (NPI-2)
- Legal business name
- Bosque Internal Medicine LLC
- Organization subpart
- No
- Enumeration date
- Sep 5, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
3301 La Mancha Dr NwAlbuquerque, NM 87104-3029
Phone 505-490-1704 · Fax 505-433-4485
Mailing address
3301 La Mancha Dr NwAlbuquerque, NM 87104-3029
Phone 505-490-1704 · Fax 505-433-4485
Authorized official
Emily Christina Deaton
Physician
5054901704
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