Healthcare Provider Details

I. General information

NPI: 1568933950
Provider Name (Legal Business Name): UNM MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2018
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MENAUL BLVD NE
ALBUQUERQUE NM
87107-1851
US

IV. Provider business mailing address

2300 MENAUL BLVD NE
ALBUQUERQUE NM
87107-1851
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-3000
  • Fax:
Mailing address:
  • Phone: 505-272-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RENEE BAUGHMAN
Title or Position: DELEGATED OFFICIAL/ SURROGATE
Credential:
Phone: 505-272-1476