Provider Demographics
NPI:1699948489
Name:MAVIGLIA, MARCELLO ARGEO (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:MARCELLO
Middle Name:ARGEO
Last Name:MAVIGLIA
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 LAFAYETTE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1123
Mailing Address - Country:US
Mailing Address - Phone:505-688-6055
Mailing Address - Fax:505-346-9402
Practice Address - Street 1:1336 LAFAYETTE DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1123
Practice Address - Country:US
Practice Address - Phone:505-688-6055
Practice Address - Fax:505-346-9402
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM90-2452084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry