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General NPI Number Information
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NPI Number | 1922134774
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Entity Type | Individual
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Provider Name | MARYAM MERATEE M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 4730 BECKNER ROAD
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City | SANTA FE
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State | NM
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Zip | 87507
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Country | US
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Telephone | 505-989-4500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2267
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City | SANTA FE
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State | NM
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Zip | 87504-2267
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Country | US
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Telephone | 505-985-5565
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0068667
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD2016-0757
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License Number State | NM
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