Healthcare Provider Details

I. General information

NPI: 1194770719
Provider Name (Legal Business Name): CHRISTOPHER RICHARD ALLIMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 GOLD AVE SW STE 1300
ALBUQUERQUE NM
87102-3274
US

IV. Provider business mailing address

6 CALLE MEDICO STE 1
SANTA FE NM
87505-4761
US

V. Phone/Fax

Practice location:
  • Phone: 505-715-4610
  • Fax: 800-398-8610
Mailing address:
  • Phone: 505-715-4610
  • Fax: 505-715-4620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2011-0434
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: