Healthcare Provider Details

I. General information

NPI: 1932337557
Provider Name (Legal Business Name): ANGELA L DRURY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL LOOP NE SUITE 115
ALBUQUERQUE NM
87109-2129
US

IV. Provider business mailing address

101 HOSPITAL LOOP NE SUITE115
ALBUQUERQUE NM
87109-2129
US

V. Phone/Fax

Practice location:
  • Phone: 505-883-6600
  • Fax: 505-883-0023
Mailing address:
  • Phone: 505-883-6600
  • Fax: 505-883-0023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number242
License Number StateNM

VIII. Authorized Official

Name: ANGELA LEE DRURY
Title or Position: OWNER
Credential:
Phone: 505-883-6600