Egerstrom, Kenneth

Egerstrom, Kenneth is an individual health care provider with primary practice located at 2050A 2Nd St Se , Kirtland Afb NM 87117-5522. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Aerospace Medicine. Allopathic & Osteopathic Physicians / Aerospace Medicine is his primary health care specialty. Egerstrom, Kenneth can be contacted via phone (505) 846-7695.

Contact Information

Primary practice address
2050A 2Nd St Se Kirtland Afb NM 87117-5522
Phone: (505) 846-7695
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101222073 Virginia
Allopathic & Osteopathic Physicians / Aerospace Medicine 2083A0100X 0101222073 Virginia

Profile Details

NPI number 1497739098
LBN Legal business name Egerstrom, Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Jul 27th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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