Healthcare Provider Details

I. General information

NPI: 1992620231
Provider Name (Legal Business Name): NEVAEH MOBILE MEDICAL PROVIDERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9151 HIGH ASSETS WAY NW
ALBUQUERQUE NM
87120-5802
US

IV. Provider business mailing address

9151 HIGH ASSETS WAY NW
ALBUQUERQUE NM
87120-5802
US

V. Phone/Fax

Practice location:
  • Phone: 505-944-5372
  • Fax:
Mailing address:
  • Phone: 505-944-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRYAN WOOD
Title or Position: EXECUTIVE DIRECTOR
Credential: MD
Phone: 505-944-5372