Healthcare Provider Details

I. General information

NPI: 1124232442
Provider Name (Legal Business Name): JOEL S. SALAND, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3717 ALTEZ ST NE
ALBUQUERQUE NM
87111-3325
US

IV. Provider business mailing address

3717 ALTEZ ST NE
ALBUQUERQUE NM
87111-3325
US

V. Phone/Fax

Practice location:
  • Phone: 505-299-8158
  • Fax:
Mailing address:
  • Phone: 505-299-8158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080H0002X
TaxonomyPediatric Hospice and Palliative Medicine Physician
License NumberNM 71-204
License Number StateNM

VIII. Authorized Official

Name: DR. JOEL S SALAND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 505-299-8158