Healthcare Provider Details

I. General information

NPI: 1477581031
Provider Name (Legal Business Name): ALAMOGORDO INTERNAL MEDICINE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 SCENIC DR
ALAMOGORDO NM
88310-8726
US

IV. Provider business mailing address

2751 SCENIC DR
ALAMOGORDO NM
88310-8726
US

V. Phone/Fax

Practice location:
  • Phone: 575-434-2965
  • Fax: 575-439-8254
Mailing address:
  • Phone: 575-434-2965
  • Fax: 575-439-8254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number20020255
License Number StateNM

VIII. Authorized Official

Name: DR. GIRIDHAR REDDY ANIREDDY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 575-434-2965