Healthcare Provider Details

I. General information

NPI: 1487748869
Provider Name (Legal Business Name): RICHARD H MING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SILVER AVE SE STE 200 PMG GI SILVER
ALBUQUERQUE NM
87106-4904
US

IV. Provider business mailing address

PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-224-7000
  • Fax: 505-244-7292
Mailing address:
  • Phone: 505-923-5356
  • Fax: 505-923-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number83260
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: