Healthcare Provider Details

I. General information

NPI: 1003557489
Provider Name (Legal Business Name): ARTHUR JOSEPH MESTAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 SONGTAN BOULEVARD UNIT 2060
OSAN AIR BASE GYEONGGI
APO AP 96278 2060
KR

IV. Provider business mailing address

777 SONGTAN BOULEVARD UNIT 2060
OSAN AIR BASE GYEONGGI
APO AP 96278 2060
KR

V. Phone/Fax

Practice location:
  • Phone: 505-784-3627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35925
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: