MEDICARE: DR. ROBERT A BIAZAK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	87-176	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	NM009C59	OTHER	NM	BLUE CROSS BLUE SHEILD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457354243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A BIAZAK M.D.

Provider Business Mailing Address
First Line	:	1720 LOUISIANA BLVD NE
Second Line	:	STE 401
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7020
Country	:	US
Telephone Number	:	505-260-4300
Fax Number	:	505-260-4338

Provider Business Practice Location Address
First Line	:	1100 CENTRAL AVE SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4930
Country	:	US
Telephone Number	:	505-841-1234
Fax Number	:	505-841-1956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/09/2007

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Directions to “ DR. ROBERT A BIAZAK M.D.” Practice Location

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