Provider Demographics
NPI:1477790327
Name:MUNETA, BEN (MD)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:MUNETA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3309C JUAN TABO NEBLVD C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-5130
Mailing Address - Country:US
Mailing Address - Phone:505-508-1654
Mailing Address - Fax:505-508-2482
Practice Address - Street 1:4824 MCMAHON BLVD NW
Practice Address - Street 2:SUITE 115
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5412
Practice Address - Country:US
Practice Address - Phone:505-792-2815
Practice Address - Fax:505-792-2812
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2015-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2007-0072207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine