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1902916190
KEVIN C MABEN
RIO RANCHO, NM
NPI
1902916190
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: NM MD2007-0510)
Enumeration Date
2006-08-30
Last Update Date
2008-08-14
Business Address
KEVIN C MABEN MD
PMG HIGH RESORT 4005 4005 HIGH RESORT BLVD
RIO RANCHO, NM 87124
Phone number: 505-462-6000
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Mailing Address
KEVIN C MABEN MD
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-5356
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