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1306930102
BENJAMIN M STAKE
ALBUQUERQUE, NM
NPI
1306930102
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: NM 93160)
Enumeration Date
2006-10-03
Last Update Date
2008-07-15
Business Address
BENJAMIN M STAKE MD
1115 CENTRAL AVE NE PMG EMERGENCY MEDICINE
ALBUQUERQUE, NM 87106-4927
Phone number: 505-841-1125
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Mailing Address
BENJAMIN M STAKE MD
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-5356
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