Provider Demographics
NPI:1073791315
Name:ABOUSLEMAN, MONA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:LEE
Last Name:ABOUSLEMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8301 GUADALUPE TRL NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87114-1122
Mailing Address - Country:US
Mailing Address - Phone:505-312-8551
Mailing Address - Fax:505-672-7917
Practice Address - Street 1:4800 HARDWARE DR NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-312-8551
Practice Address - Fax:505-672-7917
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2018-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0213207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine