Healthcare Provider Details

I. General information

NPI: 1689168403
Provider Name (Legal Business Name): ROBIN N HERMES, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 LOUSIANA BLVD. NE STE 580
ALBUQUERQUE NM
87110
US

IV. Provider business mailing address

2440 LOUSIANA BLVD. NE STE 580
ALBUQUERQUE NM
87110
US

V. Phone/Fax

Practice location:
  • Phone: 866-972-1647
  • Fax:
Mailing address:
  • Phone: 866-972-1647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number98-289
License Number StateNM

VIII. Authorized Official

Name: DR. ROBIN HERMES
Title or Position: OWNER
Credential: MD
Phone: 505-980-5098