Healthcare Provider Details

I. General information

NPI: 1669798377
Provider Name (Legal Business Name): DAVID MATTHEW HELGESON P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAN PEDRO DR SE
ALBUQUERQUE NM
87108-5153
US

IV. Provider business mailing address

1501 SAN PEDRO DR SE
ALBUQUERQUE NM
87108-5153
US

V. Phone/Fax

Practice location:
  • Phone: 505-948-7093
  • Fax:
Mailing address:
  • Phone: 505-948-7093
  • Fax: 505-846-3930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2010-0019
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: