Healthcare Provider Details

I. General information

NPI: 1255320818
Provider Name (Legal Business Name): JUDY C MCCARVER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: JUDY C WALKER MD

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 PROSPECT PL NE
ALBUQUERQUE NM
87110-4332
US

IV. Provider business mailing address

7101 PROSPECT PL NE
ALBUQUERQUE NM
87110-4332
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-7559
  • Fax: 505-888-0477
Mailing address:
  • Phone: 505-888-7559
  • Fax: 505-888-0477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number81336
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: