Moody, Irene June
Moody, Irene June is an individual health care provider with primary practice located at 3410 Indian School Rd Ne , Albuquerque NM 87106-1148. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Moody, Irene June can be contacted via phone (505) 265-7817.Contact Information
Primary practice address
3410 Indian School Rd Ne
Albuquerque NM 87106-1148
Phone: (505) 265-7817
Fax: (505) 266-1543
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 83262 | New Mexico |
Profile Details
| NPI number | 1043217102 |
|---|---|
| LBN Legal business name | Moody, Irene June |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043217102 | NPPES |
| New Mexico | MEDICAID | 30742 |
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