Healthcare Provider Details

I. General information

NPI: 1629369087
Provider Name (Legal Business Name): KATHERINE SELIGMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE SHIMEK

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE MSC 10 6000
ALBUQUERQUE NM
87106
US

IV. Provider business mailing address

2211 LOMAS BLVD NE MSC 10 6000
ALBUQUERQUE NM
87106-2719
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2610
  • Fax:
Mailing address:
  • Phone: 505-272-2610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA136703
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD2016-0564
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: