Healthcare Provider Details
I. General information
NPI: 1073772547
Provider Name (Legal Business Name): ALBUQUERQUE NEW MEXICO PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2008
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 DR MARTIN LUTHER KING JR AVE NE
ALBUQUERQUE NM
87102-3619
US
IV. Provider business mailing address
300 S PARK RD SUITE 400
HOLLYWOOD FL
33021-8593
US
V. Phone/Fax
- Phone: 505-727-8000
- Fax:
- Phone: 954-693-0000
- Fax: 954-367-8435
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
S
SCHILLINGER
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 877-693-5700