Healthcare Provider Details

I. General information

NPI: 1477909752
Provider Name (Legal Business Name): DAWID RECHUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 COMANCHE RD NE STE C
ALBUQUERQUE NM
87107-4546
US

IV. Provider business mailing address

3500 COMANCHE RD NE STE C
ALBUQUERQUE NM
87107-4546
US

V. Phone/Fax

Practice location:
  • Phone: 505-998-7200
  • Fax:
Mailing address:
  • Phone: 719-290-8955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberDR.0063034
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: