Healthcare Provider Details

I. General information

NPI: 1134680127
Provider Name (Legal Business Name): FILIP HOLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 LOUISIANA BLVD NE STE 410
ALBUQUERQUE NM
87110-5412
US

IV. Provider business mailing address

2100 LOUISIANA BLVD NE STE 410
ALBUQUERQUE NM
87110-5412
US

V. Phone/Fax

Practice location:
  • Phone: 505-724-4300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD2025-0724
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: